Robotically-controlled end effector

ABSTRACT

The present invention is directed to a surgical instrument with a robotics system, a memory device and an end effector having an elongate channel, knife position sensor(s) and a firing bar coupled to a knife. In response to drive motions initiated by the robotics system, the firing bar may translate within the elongate channel. As the firing bar translates, the sensor(s) transmit a signal to the memory device. The position of the knife may be determined from the output signals and may be communicated to the robotics system or instrument user. The sensors may be Hall Effect sensors.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. §120 to U.S. patent application Ser. No. 13/372,195, entitledROBOTICALLY-CONTROLLED END EFFECTOR, filed Feb. 13, 2012, now U.S.Patent Application Publication No. 2012/0292367, which is acontinuation-in-part application claiming priority under 35 U.S.C. §120to U.S. patent application Ser. No. 13/118,272, entitledROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH FORCE-FEEDBACKCAPABILITIES, filed on May 27, 2011, now U.S. Patent ApplicationPublication No. 2011/0290856, which is a continuation-in-partapplication claiming priority under 35 U.S.C. §120 to U.S. patentapplication Ser. No. 12/949,099, entitled SURGICAL INSTRUMENT HAVINGRECORDING CAPABILITIES, filed on Nov. 18, 2010, which issued on May 1,2012 as U.S. Pat. No. 8,167,185, which is a continuation applicationclaiming priority under 35 U.S.C. §120 to U.S. patent application Ser.No. 11/343,803, entitled SURGICAL INSTRUMENT HAVING RECORDINGCAPABILITIES, filed on Jan. 31, 2006, which issued on Dec. 7, 2010 asU.S. Pat. No. 7,845,537, the entire disclosures of which are herebyincorporated by reference herein

BACKGROUND

In general, the present invention relates to surgical instruments and,more particularly, to minimally invasive surgical instruments capable ofsensing and recording various conditions of the instrument.

Endoscopic surgical instruments are often preferred over traditionalopen surgical devices because a smaller incision tends to reduce thepost-operative recovery time and complications. Consequently,significant development has gone into a range of endoscopic surgicalinstruments that are suitable for precise placement of a distal endeffector at a desired surgical site through the cannula of a trocar.These distal end effectors engage the tissue in a number of ways toachieve a diagnostic or therapeutic effect (e.g., endocutter, grasper,cutter, staplers, clip applier, access device, drug/gene therapydelivery device, and energy device using ultrasound, RF, laser, etc.).

Known surgical staplers include an end effector that simultaneouslymakes a longitudinal incision in tissue and applies lines of staples onopposing sides of the incision. The end effector includes a pair ofcooperating jaw members that, if the instrument is intended forendoscopic or laparoscopic applications, are capable of passing througha cannula passageway. One of the jaw members receives a staple cartridgehaving at least two laterally spaced rows of staples. The other jawmember defines an anvil having staple-forming pockets aligned with therows of staples in the cartridge. The instrument includes a plurality ofreciprocating wedges which, when driven distally, pass through openingsin the staple cartridge and engage drivers supporting the staples toeffect the firing of the staples toward the anvil.

An example of a surgical stapler suitable for endoscopic applications isdescribed in U.S. Pat. No. 5,465,895, entitled SURGICAL STAPLERINSTRUMENT to Knodel et al., which discloses an endocutter with distinctclosing and firing actions. A clinician using this device is able toclose the jaw members upon tissue to position the tissue prior tofiring. Once the clinician has determined that the jaw members areproperly gripping tissue, the clinician can fire the surgical staplerwith a single firing stroke, or multiple firing strokes, depending onthe device. Firing of the surgical stapler causes severing and staplingof the tissue. The simultaneous severing and stapling avoidscomplications that may arise when performing such actions sequentiallywith surgical tools that only sever or staple.

One specific advantage of being able to close upon tissue before firingis that the clinician is able to verify via an endoscope that thedesired location for the cut has been achieved, including verifying thata sufficient amount of tissue has been captured between the opposingjaws. If an insufficient amount of tissue is captured between opposingjaws, the jaws may draw too close together resulting in pinching attheir distal ends. Pinched jaws may not effectively form closed staplesin the severed tissue. At the other extreme, an excessive amount oftissue clamped between the jaws may cause binding and an incompletefiring.

When endoscopic surgical instruments fail, they are often returned tothe manufacturer, or other entity, for analysis of the failure. If thefailure resulted in a critical class of defect in the instrument, it isnecessary for the manufacturer to determine the cause of the failure anddetermine whether a design change is required. In that case, themanufacturer may spend hundreds of man-hours analyzing a failedinstrument and attempting to reconstruct the conditions under which itfailed based only on the damage to the instrument. It can be expensiveand very challenging to analyze instrument failures in this way. Also,many of these analyses simply conclude that the failure was due toimproper use of the instrument. Accordingly, there is a need in the artfor a surgical instrument that records various conditions during its useto facilitate a failure analysis if such an analysis is later necessary.

Additionally, motor-driven surgical instruments generally do not providesufficient user feedback during the cutting and stapling operations. Ingeneral, for example, a robotically-controlled endoscopic instrumentdoes not alert the user to the deployment forces and position of thecutting instrument during the cutting and stapling operations.Consequently, motor-driven endocutters where the operations are actuatedby merely pressing a button are generally not accepted by physicians.Accordingly, there is a need in the art for a surgical instrument thatrecords end effector conditions and provides the user with feedbackduring the instrument's operation.

The foregoing discussion is intended to illustrate various aspects ofthe related art in the field of the invention at the time, and shouldnot be taken as a disavowal of claim scope.

SUMMARY

In general, the present invention is directed to a surgical instrument.In at least one form, the surgical instrument may interface with arobotics system and include a memory device and an end effector. The endeffector may comprise an elongate channel, a firing bar and a sensor ora plurality of sensors. In response to drive motions initiated by therobotics system, the firing bar is configured to translate within theelongate channel. As the firing bar translates, the voltage across thesensor, or plurality of sensors, may vary. The sensor communicates thevoltage output to the memory device; position may be determined from thevarying voltage. A cutting element may be coupled to the firing bar andthe sensor may record the positions of the cutting element as itreciprocates. In various embodiments, the memory device may include anoutput port and/or a removable storage medium.

In various embodiments, the sensor may comprise a plurality of sensors.The plurality of sensors may be Hall Effect sensors and the firing barmay have a magnetic element. The plurality of sensors may comprise twosensors positioned on an interior surface of an elongate channel; thefirst sensor may be positioned proximate to the translating magneticelement and the second sensor may be positioned distal to thetranslating magnetic element. As the magnetic element translates betweenthe sensors, the sensors output a Hall Effect voltage, which iscommunicated to the memory device. The memory device may communicate thevoltage to a visual indication screen or to the robotics system. Thememory device may compute the position of the magnetic element.

In an alternate embodiment, the sensor may comprise a coil around thefiring bar and the firing bar may have a magnetic element. As themagnetic element translates through the coil, the coil may output avoltage, which is recorded to the memory device.

In another embodiment, the sensor may comprise a plurality of digitalsensors that sense a feature of the firing bar. The output from thesensors may be communicated to a memory device.

In another general aspect of the invention, the present invention isdirected to a method of recording the state of a surgical instrument. Inat least one form, the method comprises the step of monitoring outputfrom a sensor or a plurality of sensors. The outputs representconditions of the surgical instrument. For example, the output couldrepresent the position of a translating cutting element. The method alsocomprises the step of recording the outputs to a memory device when atleast one of the conditions of the surgical instrument changes. Invarious embodiments, the method may also comprise providing the recordedoutputs to a robotics system controlling the surgical instrument or toan outside device, such as a visual indication screen.

In accordance with other embodiments of the present invention, there isprovided a surgical cutting and fastening instrument that includes anend effector that has a moveable cutting implement operably supportedtherein. A main drive shaft assembly operably interfaces with the endeffector for transmitting an actuation motion to the movable cuttingimplement therein. A gear drive train is connected to the main driveshaft assembly. A motor for actuating the gear drive train is configuredto receive control signals from a robotic system. A sensor arrangementoperably interfaces with the end effector and the robotic system tocommunicate signals indicative of forces experienced by the end effectorto said robotic system.

In accordance with other general aspects of various embodiments of thepresent invention there is provided a surgical instrument that includesan end effector. In various embodiments, the end effector comprises anelongated channel that is configured to operably support a staplecartridge therein. An anvil is movably supported relative to theelongated channel and is movable to an open position relative to astaple cartridge within the elongated channel upon application of anopening motion thereto. The anvil is movable to a closed positionrelative to the staple cartridge upon application of a closing motion tothe anvil. A tissue cutting implement is operably supported forreciprocatable movement within the elongated channel upon application ofactuation and retraction motions thereto. In certain embodiments, thesurgical instrument further comprises a shaft assembly that is connectedto the end effector and includes a drive shaft that operably interfaceswith the tissue cutting implement for transmitting the actuation andretraction motions thereto. A gear drive train operably interfaces withthe drive shaft. A motor actuates the gear drive train and is configuredto receive control signals from a robotic system. The instrument furthercomprises a sensor for determining the position of the tissue cuttingimplement. A memory device operably interfaces with the sensor to recordthe position of the tissue cutting implement along the elongatedchannel.

DRAWINGS

Various embodiments of the present invention are described herein by wayof example in conjunction with the following figures, wherein

FIGS. 1 and 2 are perspective views of a surgical cutting and fasteninginstrument according to various embodiments of the present invention;

FIGS. 3-5 are exploded views of an end effector and shaft of theinstrument according to various embodiments of the present invention;

FIG. 6 is a side view of the end effector according to variousembodiments of the present invention;

FIG. 7 is an exploded view of the handle of the instrument according tovarious embodiments of the present invention;

FIGS. 8 and 9 are partial perspective views of the handle according tovarious embodiments of the present invention;

FIG. 10 is a side view of the handle according to various embodiments ofthe present invention;

FIGS. 10A and 10B illustrate a proportional sensor that may be usedaccording to various embodiments of the present invention;

FIG. 11 is a schematic diagram of a circuit used in the instrumentaccording to various embodiments of the present invention;

FIGS. 12-13 are side views of the handle according to other embodimentsof the present invention;

FIGS. 14-22 illustrate different mechanisms for locking the closuretrigger according to various embodiments of the present invention;

FIGS. 23A-B show a universal joint (“u-joint”) that may be employed atthe articulation point of the instrument according to variousembodiments of the present invention;

FIGS. 24A-B shows a torsion cable that may be employed at thearticulation point of the instrument according to various embodiments ofthe present invention;

FIGS. 25-31 illustrate a surgical cutting and fastening instrument withpower assist according to another embodiment of the present invention;

FIGS. 32-36 illustrate a surgical cutting and fastening instrument withpower assist according to yet another embodiment of the presentinvention;

FIGS. 37-40 illustrate a surgical cutting and fastening instrument withtactile feedback to embodiments of the present invention;

FIG. 41 illustrates an exploded view of an end effector and shaft of theinstrument according to various embodiments of the present invention;

FIG. 42 illustrates a side view of the handle of a mechanicallyinstrument according to various embodiments of the present invention;

FIG. 43 illustrates an exploded view of the handle of the mechanicallyactuated instrument of FIG. 42;

FIG. 44 illustrates a block diagram of a recording system for recordingvarious conditions of the instrument according to various embodiments ofthe present invention;

FIGS. 45-46 illustrate cut away side views of a handle of the instrumentshowing various sensors according to various embodiments of the presentinvention;

FIG. 47 illustrates the end effector of the instrument showing varioussensors according to various embodiments of the present invention;

FIG. 47A illustrates a top perspective of the elongate channel of theend effector showing various sensors according to multiple embodimentsof the present invention;

FIG. 48 illustrates a firing bar of the instrument including a sensoraccording to various embodiments of the present invention;

FIG. 49 illustrates a side view of the handle, end effector, and firingbar of the instrument showing a sensor according to various embodimentsof the present invention;

FIG. 50 illustrates an exploded view of the staple channel and portionsof a staple cartridge of the instrument showing various sensorsaccording to various embodiments of the present invention;

FIG. 51 illustrates a top down view of the staple channel of theinstrument showing various sensors according to various embodiments ofthe present invention;

FIGS. 52A and 52B illustrate a flow chart showing a method for operatingthe instrument according to various embodiments;

FIG. 53 illustrates a memory chart showing exemplary recorded conditionsof the instrument according to various embodiments of the presentinvention;

FIG. 54 is a perspective view of one robotic controller embodiment;

FIG. 55 is a perspective view of one robotic surgical armcart/manipulator of a robotic system operably supporting a plurality ofsurgical tool embodiments of the present invention;

FIG. 56 is a side view of the robotic surgical arm cart/manipulatordepicted in FIG. 55;

FIG. 57 is a perspective view of an exemplary cart structure withpositioning linkages for operably supporting robotic manipulators thatmay be used with various surgical tool embodiments of the presentinvention;

FIG. 58 is a perspective view of a surgical tool embodiment of thepresent invention;

FIG. 59 is an exploded assembly view of an adapter and tool holderarrangement for attaching various surgical tool embodiments to a roboticsystem;

FIG. 60 is a side view of the adapter shown in FIG. 59;

FIG. 61 is a bottom view of the adapter shown in FIG. 59;

FIG. 62 is a top view of the adapter of FIGS. 59 and 60;

FIG. 63 is a partial bottom perspective view of the surgical toolembodiment of FIG. 58;

FIG. 64 is a partial exploded view of a portion of an articulatablesurgical end effector embodiment of the present invention;

FIG. 65 is a perspective view of the surgical tool embodiment of FIG. 63with the tool mounting housing removed;

FIG. 66 is a rear perspective view of the surgical tool embodiment ofFIG. 63 with the tool mounting housing removed;

FIG. 67 is a front perspective view of the surgical tool embodiment ofFIG. 63 with the tool mounting housing removed;

FIG. 68 is a partial exploded perspective view of the surgical toolembodiment of FIG. 67;

FIG. 69 is a partial cross-sectional side view of the surgical toolembodiment of FIG. 63;

FIG. 70 is an enlarged cross-sectional view of a portion of the surgicaltool depicted in FIG. 69;

FIG. 71 is an exploded perspective view of a portion of the toolmounting portion of the surgical tool embodiment depicted in FIG. 63;

FIG. 72 is an enlarged exploded perspective view of a portion of thetool mounting portion of FIG. 71;

FIG. 73 is a partial cross-sectional view of a portion of the elongatedshaft assembly of the surgical tool of FIG. 63;

FIG. 74 is a side view of a half portion of a closure nut embodiment ofa surgical tool embodiment of the present invention;

FIG. 75 is a perspective view of another surgical tool embodiment of thepresent invention;

FIG. 76 is a cross-sectional side view of a portion of the surgical endeffector and elongated shaft assembly of the surgical tool embodiment ofFIG. 75 with the anvil in the open position and the closure clutchassembly in a neutral position;

FIG. 77 is another cross-sectional side view of the surgical endeffector and elongated shaft assembly shown in FIG. 76 with the clutchassembly engaged in a closure position;

FIG. 78 is another cross-sectional side view of the surgical endeffector and elongated shaft assembly shown in FIG. 76 with the clutchassembly engaged in a firing position;

FIG. 79 is a top view of a portion of a tool mounting portion embodimentof the present invention;

FIG. 80 is a perspective view of another surgical tool embodiment of thepresent invention;

FIG. 81 is a cross-sectional side view of a portion of the surgical endeffector and elongated shaft assembly of the surgical tool embodiment ofFIG. 80 with the anvil in the open position;

FIG. 82 is another cross-sectional side view of a portion of thesurgical end effector and elongated shaft assembly of the surgical toolembodiment of FIG. 80 with the anvil in the closed position;

FIG. 83 is a perspective view of a closure drive nut and portion of aknife bar embodiment of the present invention;

FIG. 84 is a top view of another tool mounting portion embodiment of thepresent invention;

FIG. 85 is a perspective view of another surgical tool embodiment of thepresent invention;

FIG. 86 is a cross-sectional side view of a portion of the surgical endeffector and elongated shaft assembly of the surgical tool embodiment ofFIG. 85 with the anvil in the open position;

FIG. 87 is another cross-sectional side view of a portion of thesurgical end effector and elongated shaft assembly of the surgical toolembodiment of FIG. 86 with the anvil in the closed position;

FIG. 88 is a cross-sectional view of a mounting collar embodiment of asurgical tool embodiment of the present invention showing the knife barand distal end portion of the closure drive shaft;

FIG. 89 is a cross-sectional view of the mounting collar embodiment ofFIG. 88;

FIG. 90 is a top view of another tool mounting portion embodiment ofanother surgical tool embodiment of the present invention;

FIG. 90A is an exploded perspective view of a portion of a geararrangement of another surgical tool embodiment of the presentinvention;

FIG. 90B is a cross-sectional perspective view of the gear arrangementshown in FIG. 90A;

FIG. 91 is a cross-sectional side view of a portion of a surgical endeffector and elongated shaft assembly of another surgical toolembodiment of the present invention employing a pressure sensorarrangement with the anvil in the open position;

FIG. 92 is another cross-sectional side view of a portion of thesurgical end effector and elongated shaft assembly of the surgical toolembodiment of FIG. 91 with the anvil in the closed position;

FIG. 93 is a side view of a portion of another surgical tool embodimentof the present invention in relation to a tool holder portion of arobotic system with some of the components thereof shown incross-section;

FIG. 94 is a side view of a portion of another surgical tool embodimentof the present invention in relation to a tool holder portion of arobotic system with some of the components thereof shown incross-section;

FIG. 95 is a side view of a portion of another surgical tool embodimentof the present invention with some of the components thereof shown incross-section;

FIG. 96 is a side view of a portion of another surgical end effectorembodiment of a portion of a surgical tool embodiment of the presentinvention with some components thereof shown in cross-section;

FIG. 97 is a side view of a portion of another surgical end effectorembodiment of a portion of a surgical tool embodiment of the presentinvention with some components thereof shown in cross-section;

FIG. 98 is a side view of a portion of another surgical end effectorembodiment of a portion of a surgical tool embodiment of the presentinvention with some components thereof shown in cross-section;

FIG. 99 is an enlarged cross-sectional view of a portion of the endeffector of FIG. 98;

FIG. 100 is another cross-sectional view of a portion of the endeffector of FIGS. 98 and 99;

FIG. 101 is a cross-sectional side view of a portion of a surgical endeffector and elongated shaft assembly of another surgical toolembodiment of the present invention with the anvil in the open position;

FIG. 102 is an enlarged cross-sectional side view of a portion of thesurgical end effector and elongated shaft assembly of the surgical toolembodiment of FIG. 101;

FIG. 103 is another cross-sectional side view of a portion of thesurgical end effector and elongated shaft assembly of FIGS. 101 and 102with the anvil thereof in the closed position;

FIG. 104 is an enlarged cross-sectional side view of a portion of thesurgical end effector and elongated shaft assembly of the surgical toolembodiment of FIGS. 101-103;

FIG. 105 is a top view of a tool mounting portion embodiment of asurgical tool embodiment of the present invention;

FIG. 106 is a perspective assembly view of another surgical toolembodiment of the present invention;

FIG. 107 is a front perspective view of a disposable loading unitarrangement that may be employed with various surgical tool embodimentsof the present invention;

FIG. 108 is a rear perspective view of the disposable loading unit ofFIG. 107;

FIG. 109 is a bottom perspective view of the disposable loading unit ofFIGS. 107 and 108;

FIG. 110 is a bottom perspective view of another disposable loading unitembodiment that may be employed with various surgical tool embodimentsof the present invention;

FIG. 111 is an exploded perspective view of a mounting portion of adisposable loading unit depicted in FIGS. 107-109;

FIG. 112 is a perspective view of a portion of a disposable loading unitand an elongated shaft assembly embodiment of a surgical tool embodimentof the present invention with the disposable loading unit in a firstposition;

FIG. 113 is another perspective view of a portion of the disposableloading unit and elongated shaft assembly of FIG. 112 with thedisposable loading unit in a second position;

FIG. 114 is a cross-sectional view of a portion of the disposableloading unit and elongated shaft assembly embodiment depicted in FIGS.112 and 113;

FIG. 115 is another cross-sectional view of the disposable loading unitand elongated shaft assembly embodiment depicted in FIGS. 112-114;

FIG. 116 is a partial exploded perspective view of a portion of anotherdisposable loading unit embodiment and an elongated shaft assemblyembodiment of a surgical tool embodiment of the present invention;

FIG. 117 is a partial exploded perspective view of a portion of anotherdisposable loading unit embodiment and an elongated shaft assemblyembodiment of a surgical tool embodiment of the present invention;

FIG. 118 is another partial exploded perspective view of the disposableloading unit embodiment and an elongated shaft assembly embodiment ofFIG. 117;

FIG. 119 is a top view of another tool mounting portion embodiment of asurgical tool embodiment of the present invention;

FIG. 120 is a side view of another surgical tool embodiment of thepresent invention with some of the components thereof shown incross-section and in relation to a robotic tool holder of a roboticsystem;

FIG. 121 is an exploded assembly view of a surgical end effectorembodiment that may be used in connection with various surgical toolembodiments of the present invention;

FIG. 122 is a side view of a portion of a cable-driven system fordriving a cutting instrument employed in various surgical end effectorembodiments of the present invention;

FIG. 123 is a top view of the cable-driven system and cutting instrumentof FIG. 122;

FIG. 124 is a top view of a cable drive transmission embodiment of thepresent invention in a closure position;

FIG. 125 is another top view of the cable drive transmission embodimentof FIG. 124 in a neutral position;

FIG. 126 is another top view of the cable drive transmission embodimentof FIGS. 124 and 125 in a firing position;

FIG. 127 is a perspective view of the cable drive transmissionembodiment in the position depicted in FIG. 124;

FIG. 128 is a perspective view of the cable drive transmissionembodiment in the position depicted in FIG. 125;

FIG. 129 is a perspective view of the cable drive transmissionembodiment in the position depicted in FIG. 126;

FIG. 130 is a perspective view of another surgical tool embodiment ofthe present invention;

FIG. 131 is a side view of a portion of another cable-driven systemembodiment for driving a cutting instrument employed in various surgicalend effector embodiments of the present invention;

FIG. 132 is a top view of the cable-driven system embodiment of FIG.131;

FIG. 133 is a top view of a tool mounting portion embodiment of anothersurgical tool embodiment of the present invention;

FIG. 134 is a top cross-sectional view of another surgical toolembodiment of the present invention;

FIG. 135 is a cross-sectional view of a portion of a surgical endeffector embodiment of a surgical tool embodiment of the presentinvention;

FIG. 136 is a cross-sectional end view of the surgical end effector ofFIG. 103 taken along line 136-136 in FIG. 135;

FIG. 137 is a perspective view of the surgical end effector of FIGS. 135and 136 with portions thereof shown in cross-section;

FIG. 138 is a side view of a portion of the surgical end effector ofFIGS. 135-137;

FIG. 139 is a perspective view of a sled assembly embodiment of varioussurgical tool embodiments of the present invention;

FIG. 140 is a cross-sectional view of the sled assembly embodiment ofFIG. 139 and a portion of the elongated channel of FIG. 138;

FIGS. 141-146 diagrammatically depict the sequential firing of staplesin a surgical tool embodiment of the present invention;

FIG. 147 is a partial perspective view of a portion of a surgical endeffector embodiment of the present invention;

FIG. 148 is a partial cross-sectional perspective view of a portion of asurgical end effector embodiment of a surgical tool embodiment of thepresent invention;

FIG. 149 is another partial cross-sectional perspective view of thesurgical end effector embodiment of FIG. 148 with a sled assemblyaxially advancing therethrough;

FIG. 150 is a perspective view of another sled assembly embodiment ofanother surgical tool embodiment of the present invention;

FIG. 151 is a partial top view of a portion of the surgical end effectorembodiment depicted in FIGS. 148 and 149 with the sled assembly axiallyadvancing therethrough;

FIG. 152 is another partial top view of the surgical end effectorembodiment of FIG. 151 with the top surface of the surgical staplecartridge omitted for clarity;

FIG. 153 is a partial cross-sectional side view of a rotary driverembodiment and staple pusher embodiment of the surgical end effectordepicted in FIGS. 148 and 149;

FIG. 154 is a perspective view of an automated reloading systemembodiment of the present invention with a surgical end effector inextractive engagement with the extraction system thereof;

FIG. 155 is another perspective view of the automated reloading systemembodiment depicted in FIG. 154;

FIG. 156 is a cross-sectional elevational view of the automatedreloading system embodiment depicted in FIGS. 154 and 155;

FIG. 157 is another cross-sectional elevational view of the automatedreloading system embodiment depicted in FIGS. 154-156 with theextraction system thereof removing a spent surgical staple cartridgefrom the surgical end effector;

FIG. 158 is another cross-sectional elevational view of the automatedreloading system embodiment depicted in FIGS. 154-157 illustrating theloading of a new surgical staple cartridge into a surgical end effector;

FIG. 159 is a perspective view of another automated reloading systemembodiment of the present invention with some components shown incross-section;

FIG. 160 is an exploded perspective view of a portion of the automatedreloading system embodiment of FIG. 159;

FIG. 161 is another exploded perspective view of the portion of theautomated reloading system embodiment depicted in FIG. 160;

FIG. 162 is a cross-sectional elevational view of the automatedreloading system embodiment of FIGS. 159-161;

FIG. 163 is a cross-sectional view of an orientation tube embodimentsupporting a disposable loading unit therein;

FIG. 164 is a perspective view of another surgical tool embodiment ofthe present invention;

FIG. 165 is a partial perspective view of an articulation jointembodiment of a surgical tool embodiment of the present invention;

FIG. 166 is a perspective view of a closure tube embodiment of asurgical tool embodiment of the present invention;

FIG. 167 is a perspective view of the closure tube embodiment of FIG.166 assembled on the articulation joint embodiment of FIG. 165;

FIG. 168 is a top view of a portion of a tool mounting portionembodiment of a surgical tool embodiment of the present invention;

FIG. 169 is a perspective view of an articulation drive assemblyembodiment employed in the tool mounting portion embodiment of FIG. 168;

FIG. 170 is a perspective view of another surgical tool embodiment ofthe present invention;

FIG. 171 is a perspective view of another surgical tool embodiment ofthe present invention; and

FIG. 172 is a perspective view of another surgical cutting and fasteningtool according to various embodiments of the present invention depictingan inductive coupling.

DETAILED DESCRIPTION

Applicant of the present application also owns the following patentapplications, which are each herein incorporated by reference in theirrespective entireties:

-   -   U.S. patent application Ser. No. 11/343,498, now U.S. Pat. No.        7,766,210, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING        INSTRUMENT WITH USER FEEDBACK SYSTEM    -   U.S. patent application Ser. No. 11/343,573, now U.S. Pat. No.        7,416,101, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING        INSTRUMENT WITH LOADING FORCE FEEDBACK    -   U.S. patent application Ser. No. 11/344,035, now U.S. Pat. No.        7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING        INSTRUMENT WITH TACTILE POSITION FEEDBACK    -   U.S. patent application Ser. No. 11/343,447, now U.S. Pat. No.        7,770,775, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING        INSTRUMENT WITH ADAPTIVE USER FEEDBACK    -   U.S. patent application Ser. No. 11/343,562, now U.S. Pat. No.        7,568,603, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING        INSTRUMENT WITH ARTICULATABLE END EFFECTOR    -   U.S. patent application Ser. No. 11/344,024, now U.S. Pat. No.        8,186,555, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING        INSTRUMENT WITH MECHANICAL CLOSURE SYSTEM    -   U.S. patent application Ser. No. 11/343,321, now U.S. Patent        Application Publication No. 2007/0175955, entitled SURGICAL        CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING        MECHANISM    -   U.S. patent application Ser. No. 11/343,563, now U.S. Patent        Application Publication No. 2007/0175951, entitled GEARING        SELECTOR FOR A POWERED SURGICAL CUTTING AND FASTENING STAPLING        INSTRUMENT    -   U.S. patent application Ser. No. 11/344,020, now U.S. Pat. No.        7,464,846, entitled SURGICAL INSTRUMENT HAVING A REMOVABLE        BATTERY    -   U.S. patent application Ser. No. 11/343,439, now U.S. Pat. No.        7,644,848, entitled ELECTRONIC LOCKOUTS AND SURGICAL INSTRUMENT        INCLUDING SAME    -   U.S. patent application Ser. No. 11/343,547, now U.S. Pat. No.        7,753,904, entitled ENDOSCOPIC SURGICAL INSTRUMENT WITH A HANDLE        THAT CAN ARTICULATE WITH RESPECT TO THE SHAFT    -   U.S. patent application Ser. No. 11/344,021, now U.S. Pat. No.        7,464,849, entitled ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH        CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS    -   U.S. patent application Ser. No. 11/343,546, now U.S. Patent        Application Publication No. 2007/0175950, entitled DISPOSABLE        STAPLE CARTRIDGE HAVING AN ANVIL WITH TISSUE LOCATOR FOR USE        WITH A SURGICAL CUTTING AND FASTENING INSTRUMENT AND MODULAR END        EFFECTOR SYSTEM THEREFOR    -   U.S. patent application Ser. No. 11/343,545, now U.S. Pat. No.        8,708,213, entitled SURGICAL INSTRUMENT HAVING A FEEDBACK SYSTEM    -   U.S. patent application Ser. No. 13/021,105, now U.S. Pat. No.        8,172,124, entitled SURGICAL INSTRUMENT HAVING RECORDING        CAPABILITIES    -   U.S. patent application Ser. No. 13/118,259, now U.S. Pat. No.        8,684,253, entitled SURGICAL INSTRUMENT WITH WIRELESS        COMMUNICATION BETWEEN A CONTROL UNIT OF A ROBOTIC SYSTEM AND        REMOTE SENSOR    -   U.S. patent application Ser. No. 13/118,210, now U.S. Pat. No.        8,752,749, entitled ROBOTICALLY-CONTROLLED DISPOSABLE MOTOR        DRIVEN LOADING UNIT    -   U.S. patent application Ser. No. 13/118,194, now U.S. Pat. No.        8,992,422, entitled ROBOTICALLY-CONTROLLED ENDOSCOPIC ACCESSORY        CHANNEL    -   U.S. patent application Ser. No. 13/118,253, now U.S. Patent        Application Publication No. 2011/0295269, entitled        ROBOTICALLY-CONTROLLED MOTORIZED SURGICAL INSTRUMENT    -   U.S. patent application Ser. No. 13/118,278, now U.S. Pat. No.        9,237,891, entitled ROBOTICALLY-CONTROLLED SURGICAL STAPLING        DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS    -   U.S. patent application Ser. No. 13/118,190, now U.S. Pat. No.        9,179,912, entitled ROBOTICALLY-CONTROLLED MOTORIZED SURGICAL        CUTTING AND FASTENING INSTRUMENT    -   U.S. patent application Ser. No. 13/118,223, now U.S. Pat. No.        8,931,682, entitled ROBOTICALLY-CONTROLLED SHAFT BASED ROTARY        DRIVE SYSTEMS FOR SURGICAL INSTRUMENTS    -   U.S. patent application Ser. No. 13/118,263, now U.S. Patent        Application Publication No. 2011/0295295, entitled        ROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT HAVING RECORDING        CAPABILITIES    -   U.S. patent application Ser. No. 13/118,246, now U.S. Pat. No.        9,060,770, entitled ROBOTICALLY-DRIVEN SURGICAL INSTRUMENT WITH        E-BEAM DRIVER    -   U.S. patent application Ser. No. 13/118,241, now U.S. Pat. No.        9,072,535, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE        STAPLE DEPLOYMENT ARRANGEMENTS    -   U.S. patent application Ser. No. 13/372,205, now U.S. Pat. No.        9,044,230, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT        WITH APPARATUS FOR DETERMINING CARTRIDGE AND FIRING MOTION        STATUS

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting, exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

Uses of the phrases “in various embodiments,” “in some embodiments,” “inone embodiment”, or “in an embodiment”, or the like, throughout thespecification are not necessarily all referring to the same embodiment.Furthermore, the particular features, structures, or characteristics ofone or more embodiments may be combined in any suitable manner in one ormore other embodiments. Such modifications and variations are intendedto be included within the scope of the present invention.

Endoscopic Surgical Instruments

FIGS. 1 and 2 depict a surgical cutting and fastening instrument 10according to various embodiments of the present invention. Theillustrated embodiment is an endoscopic surgical instrument 10 and ingeneral, the embodiments of the instrument 10 described herein areendoscopic surgical cutting and fastening instruments. It should benoted, however, that according to other embodiments of the presentinvention, the instrument 10 may be a non-endoscopic surgical cuttinginstrument, such as a laproscopic instrument.

The surgical instrument 10 depicted in FIGS. 1 and 2 comprises a handle6, a shaft 8, and an articulating end effector 12 pivotally connected tothe shaft 8 at an articulation pivot 14. An articulation control 16 maybe provided adjacent to the handle 6 to effect rotation of the endeffector 12 about the articulation pivot 14. It will be appreciated thatvarious embodiments may include a non-pivoting end effector, andtherefore may not have an articulation pivot 14 or articulation control16. Also, in the illustrated embodiment, the end effector 12 isconfigured to act as an endocutter for clamping, severing and staplingtissue, although, in other embodiments, different types of end effectorsmay be used, such as end effectors for other types of surgical devices,such as graspers, cutters, staplers, clip appliers, access devices,drug/gene therapy devices, ultrasound, RF or laser devices, etc.

The handle 6 of the instrument 10 may include a closure trigger 18 and afiring trigger 20 for actuating the end effector 12. It will beappreciated that instruments having end effectors directed to differentsurgical tasks may have different numbers or types of triggers or othersuitable controls for operating the end effector 12. The end effector 12is shown separated from the handle 6 by a preferably elongate shaft 8.In one embodiment, a clinician or operator of the instrument 10 mayarticulate the end effector 12 relative to the shaft 8 by utilizing thearticulation control 16, as described in more detail in U.S. patentapplication Ser. No. 11/329,020, filed Jan. 10, 2006, which issued onMar. 2, 2010 as U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENTHAVING AN ARTICULATING END EFFECTOR, by Geoffrey C. Hueil et al., whichis incorporated herein by reference.

In this example, the end effector 12 includes, among other things, astaple channel 22 and a pivotally translatable clamping member, such asan anvil 24, which are maintained at a spacing that assures effectivestapling and severing of tissue clamped in the end effector 12. Thehandle 6 includes a pistol grip 26 toward which a closure trigger 18 ispivotally drawn by the clinician to cause clamping or closing of theanvil 24 towards the staple channel 22 of the end effector 12 to therebyclamp tissue positioned between the anvil 24 and channel 22. The firingtrigger 20 is farther outboard of the closure trigger 18. Once theclosure trigger 18 is locked in the closure position as furtherdescribed below, the firing trigger 20 may rotate slightly toward thepistol grip 26 so that it can be reached by the operator using one hand.Then the operator may pivotally draw the firing trigger 20 toward thepistol grip 26 to cause the stapling and severing of clamped tissue inthe end effector 12. In other embodiments, different types of clampingmembers besides the anvil 24 could be used, such as, for example, anopposing jaw, etc.

It will be appreciated that the terms “proximal” and “distal” are usedherein with reference to a clinician gripping the handle 6 of aninstrument 10. Thus, the end effector 12 is distal with respect to themore proximal handle 6. It will be further appreciated that, forconvenience and clarity, spatial terms such as “vertical” and“horizontal” are used herein with respect to the drawings. However,surgical instruments are used in many orientations and positions, andthese terms are not intended to be limiting and absolute.

The closure trigger 18 may be actuated first. Once the clinician issatisfied with the positioning of the end effector 12, the clinician maydraw back the closure trigger 18 to its fully closed, locked positionproximate to the pistol grip 26. The firing trigger 20 may then beactuated. The firing trigger 20 returns to the open position (shown inFIGS. 1 and 2) when the clinician removes pressure, as described morefully below. A release button on the handle 6, when depressed mayrelease the locked closure trigger 18. The release button may beimplemented in various forms such as, for example, release button 30shown in FIGS. 42-43, slide release button 160 shown in FIG. 14, and/orbutton 172 shown in FIG. 16.

FIGS. 3-6 show embodiments of a rotary-driven end effector 12 and shaft8 according to various embodiments. FIG. 3 is an exploded view of theend effector 12 according to various embodiments. As shown in theillustrated embodiment, the end effector 12 may include, in addition tothe previously-mentioned channel 22 and anvil 24, a cutting instrument32, a sled 33, a staple cartridge 34 that is removably seated in thechannel 22, and a helical screw shaft 36. The cutting instrument 32 maybe, for example, a knife. The anvil 24 may be pivotably opened andclosed at pivot pins 25 connected to the proximate end of the channel22. The anvil 24 may also include a tab 27 at its proximate end that isinserted into a component of the mechanical closure system (describedfurther below) to open and close the anvil 24. When the closure trigger18 is actuated, that is, drawn in by a user of the instrument 10, theanvil 24 may pivot about the pivot pins 25 into the clamped or closedposition. If clamping of the end effector 12 is satisfactory, theoperator may actuate the firing trigger 20, which, as explained in moredetail below, causes the knife 32 and sled 33 to travel longitudinallyalong the channel 22, thereby cutting tissue clamped within the endeffector 12. The movement of the sled 33 along the channel 22 causes thestaples (not shown) of the staple cartridge 34 to be driven through thesevered tissue and against the closed anvil 24, which turns the staplesto fasten the severed tissue. In various embodiments, the sled 33 may bean integral component of the cartridge 34. U.S. Pat. No. 6,978,921,entitled SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRINGMECHANISM to Shelton, IV et al., which is incorporated herein byreference, provides more details about such two-stroke cutting andfastening instruments. The sled 33 may be part of the cartridge 34, suchthat when the knife 32 retracts following the cutting operation, thesled 33 does not retract.

It should be noted that although the embodiments of the instrument 10described herein employ an end effector 12 that staples the severedtissue, in other embodiments different techniques for fastening orsealing the severed tissue may be used. For example, end effectors thatuse RF energy or adhesives to fasten the severed tissue may also beused. U.S. Pat. No. 5,709,680, entitled ELECTROSURGICAL HEMOSTATICDEVICE to Yates et al., and U.S. Pat. No. 5,688,270, entitledELECTROSURGICAL HEMOSTATIC DEVICE WITH RECESSED AND/OR OFFSET ELECTRODESto Yates et al. which are incorporated herein by reference, disclose anendoscopic cutting instrument that uses RF energy to seal the severedtissue. U.S. patent application Ser. No. 11/267,811 to Jerome R. Morgan,et. al, and U.S. patent application Ser. No. 11/267,383 to Frederick E.Shelton, IV, et. al, which are also incorporated herein by reference,disclose cutting instruments that uses adhesives to fasten the severedtissue. Accordingly, although the description herein refers tocutting/stapling operations and the like below, it should be recognizedthat this is an exemplary embodiment and is not meant to be limiting.Other tissue fastening techniques may also be used.

FIGS. 4 and 5 are exploded views and FIG. 6 is a side view of the endeffector 12 and shaft 8 according to various embodiments. As shown inthe illustrated embodiment, the shaft 8 may include a proximate closuretube 40 and a distal closure tube 42 pivotably linked by a pivot link44. The distal closure tube 42 includes an opening 45 into which the tab27 on the anvil 24 is inserted in order to open and close the anvil 24,as further described below. Disposed inside the closure tubes 40, 42 maybe a proximate spine tube 46. Disposed inside the proximate spine tube46 may be a main rotational (or proximate) drive shaft 48 thatcommunicates with a secondary (or distal) drive shaft 50 via a bevelgear assembly 52. The secondary drive shaft 50 is connected to a drivegear 54 that engages a proximate drive gear 56 of the helical screwshaft 36. The vertical bevel gear 52 b may sit and pivot in an opening57 in the distal end of the proximate spine tube 46. A distal spine tube58 may be used to enclose the secondary drive shaft 50 and the drivegears 54, 56. Collectively, the main drive shaft 48, the secondary driveshaft 50, and the articulation assembly (e.g., the bevel gear assembly52 a-c) are sometimes referred to herein as the “main drive shaftassembly.”

A bearing 38, positioned at a distal end of the staple channel 22,receives the helical drive screw 36, allowing the helical drive screw 36to freely rotate with respect to the channel 22. The helical screw shaft36 may interface a threaded opening (not shown) of the knife 32 suchthat rotation of the shaft 36 causes the knife 32 to translate distallyor proximately (depending on the direction of the rotation) through thestaple channel 22. Accordingly, when the main drive shaft 48 is causedto rotate by actuation of the firing trigger 20 (as explained in moredetail below), the bevel gear assembly 52 a-c causes the secondary driveshaft 50 to rotate, which in turn, because of the engagement of thedrive gears 54, 56, causes the helical screw shaft 36 to rotate, whichcauses the knife driving member 32 to travel longitudinally along thechannel 22 to cut any tissue clamped within the end effector 12. Thesled 33 may be made of, for example, plastic, and may have a slopeddistal surface. As the sled 33 traverses the channel 22, the slopedforward surface may push up or drive the staples in the staple cartridgethrough the clamped tissue and against the anvil 24. The anvil 24 turnsthe staples, thereby stapling the severed tissue. When the knife 32 isretracted, the knife 32 and sled 33 may become disengaged, therebyleaving the sled 33 at the distal end of the channel 22.

Motor-Driven Instrument with Helical Gear Drum

As described above, because of the lack of user feedback for thecutting/stapling operation, there is a general lack of acceptance amongphysicians of motor-driven endocutters where the cutting/staplingoperation is actuated by merely pressing a button. In contrast,embodiments of the present invention provide a motor-driven endocutterwith user-feedback of the deployment, force and/or position of thecutting instrument 32 in end effector 12.

FIGS. 7-10 illustrate an exemplary embodiment of a motor-drivenendocutter, and in particular the handle thereof, that providesuser-feedback regarding the deployment and loading force of the cuttinginstrument 32 in the end effector 12. In addition, the embodiment mayuse power provided by the user in retracting the firing trigger 20 topower the device (a so-called “power assist” mode). The embodiment maybe used with the rotary driven end effector 12 and shaft 8 embodimentsdescribed above. As shown in the illustrated embodiment, the handle 6includes exterior lower side pieces 59, 60 and exterior upper sidepieces 61, 62 that fit together to form, in general, the exterior of thehandle 6. A battery 64, such as a Li ion battery, may be provided in thepistol grip portion 26 of the handle 6. The battery 64 powers a motor 65disposed in an upper portion of the pistol grip portion 26 of the handle6. According to various embodiments, the motor 65 may be a DC brusheddriving motor having a maximum rotation of, approximately, 5000 RPM. Themotor 65 may drive a 90° bevel gear assembly 66 comprising a first bevelgear 68 and a second bevel gear 70. The bevel gear assembly 66 may drivea planetary gear assembly 72. The planetary gear assembly 72 may includea pinion gear 74 connected to a drive shaft 76. The pinion gear 74 maydrive a mating ring gear 78 that drives a helical gear drum 80 via adrive shaft 82. A ring 84 may be threaded on the helical gear drum 80.Thus, when the motor 65 rotates, the ring 84 is caused to travel alongthe helical gear drum 80 by means of the interposed bevel gear assembly66, planetary gear assembly 72 and ring gear 78.

The handle 6 may also include a run motor sensor 110 (see FIG. 10) incommunication with the firing trigger 20 to detect when the firingtrigger 20 has been drawn in (or “closed”) toward the pistol gripportion 26 of the handle 6 by the operator to thereby actuate thecutting/stapling operation by the end effector 12. The sensor 110 may bea proportional sensor such as, for example, a rheostat or variableresistor. When the firing trigger 20 is drawn in, the sensor 110 detectsthe movement, and sends an electrical signal indicative of the voltage(or power) to be supplied to the motor 65. When the sensor 110 is avariable resistor or the like, the rotation of the motor 65 may begenerally proportional to the amount of movement of the firing trigger20. That is, if the operator only draws or closes the firing trigger 20in a little bit, the rotation of the motor 65 is relatively low. Whenthe firing trigger 20 is fully drawn in (or in the fully closedposition), the rotation of the motor 65 is at its maximum. In otherwords, the harder the user pulls on the firing trigger 20, the morevoltage is applied to the motor 65, causing greater rates of rotation.

The handle 6 may include a middle handle piece 104 adjacent to the upperportion of the firing trigger 20. The handle 6 also may comprise a biasspring 112 connected between posts on the middle handle piece 104 andthe firing trigger 20. The bias spring 112 may bias the firing trigger20 to its fully open position. In that way, when the operator releasesthe firing trigger 20, the bias spring 112 will pull the firing trigger20 to its open position, thereby removing actuation of the sensor 110,thereby stopping rotation of the motor 65. Moreover, by virtue of thebias spring 112, any time a user closes the firing trigger 20, the userwill experience resistance to the closing operation, thereby providingthe user with feedback as to the amount of rotation exerted by the motor65. Further, the operator could stop retracting the firing trigger 20 tothereby remove force from the sensor 110, to thereby stop the motor 65.As such, the user may stop the deployment of the end effector 12,thereby providing a measure of control of the cutting/fasteningoperation to the operator.

The distal end of the helical gear drum 80 includes a distal drive shaft120 that drives a ring gear 122, which mates with a pinion gear 124. Thepinion gear 124 is connected to the main drive shaft 48 of the maindrive shaft assembly. In that way, rotation of the motor 65 causes themain drive shaft assembly to rotate, which causes actuation of the endeffector 12, as described above.

The ring 84 threaded on the helical gear drum 80 may include a post 86that is disposed within a slot 88 of a slotted arm 90. The slotted arm90 has an opening 92 in its opposite end 94 that receives a pivot pin 96that is connected between the handle exterior side pieces 59, 60. Thepivot pin 96 is also disposed through an opening 100 in the firingtrigger 20 and an opening 102 in the middle handle piece 104.

In addition, the handle 6 may include a reverse motor sensor (orend-of-stroke sensor) 130 and a stop motor (or beginning-of-stroke)sensor 142. In various embodiments, the reverse motor sensor 130 may bea limit switch located at the distal end of the helical gear drum 80such that the ring 84 threaded on the helical gear drum 80 contacts andtrips the reverse motor sensor 130 when the ring 84 reaches the distalend of the helical gear drum 80. The reverse motor sensor 130, whenactivated, sends a signal to the motor 65 to reverse its rotationdirection, thereby withdrawing the knife 32 of the end effector 12following the cutting operation.

The stop motor sensor 142 may be, for example, a normally-closed limitswitch. In various embodiments, it may be located at the proximate endof the helical gear drum 80 so that the ring 84 trips the switch 142when the ring 84 reaches the proximate end of the helical gear drum 80.

In operation, when an operator of the instrument 10 pulls back thefiring trigger 20, the sensor 110 detects the deployment of the firingtrigger 20 and sends a signal to the motor 65 to cause forward rotationof the motor 65, for example, at a rate proportional to how hard theoperator pulls back the firing trigger 20. The forward rotation of themotor 65 in turn causes the ring gear 78 at the distal end of theplanetary gear assembly 72 to rotate, thereby causing the helical geardrum 80 to rotate, causing the ring 84 threaded on the helical gear drum80 to travel distally along the helical gear drum 80. The rotation ofthe helical gear drum 80 also drives the main drive shaft assembly asdescribed above, which in turn causes deployment of the knife 32 in theend effector 12. That is, the knife 32 and sled 33 are caused totraverse the channel 22 longitudinally, thereby cutting tissue clampedin the end effector 12. Also, the stapling operation of the end effector12 is caused to happen in embodiments where a stapling-type end effector12 is used.

By the time the cutting/stapling operation of the end effector 12 iscomplete, the ring 84 on the helical gear drum 80 will have reached thedistal end of the helical gear drum 80, thereby causing the reversemotor sensor 130 to be tripped, which sends a signal to the motor 65 tocause the motor 65 to reverse its rotation. This in turn causes theknife 32 to retract, and also causes the ring 84 on the helical geardrum 80 to move back to the proximate end of the helical gear drum 80.

The middle handle piece 104 includes a backside shoulder 106 thatengages the slotted arm 90 as best shown in FIGS. 8 and 9. The middlehandle piece 104 also has a forward motion stop 107 that engages thefiring trigger 20. The movement of the slotted arm 90 is controlled, asexplained above, by rotation of the motor 65. When the slotted arm 90rotates counter clockwise as the ring 84 travels from the proximate endof the helical gear drum 80 to the distal end, the middle handle piece104 will be free to rotate counter clockwise. Thus, as the user draws inthe firing trigger 20, the firing trigger 20 will engage the forwardmotion stop 107 of the middle handle piece 104, causing the middlehandle piece 104 to rotate counter clockwise. Due to the backsideshoulder 106 engaging the slotted arm 90, however, the middle handlepiece 104 will only be able to rotate counter clockwise as far as theslotted arm 90 permits. In that way, if the motor 65 should stoprotating for some reason, the slotted arm 90 will stop rotating, and theuser will not be able to further draw in the firing trigger 20 becausethe middle handle piece 104 will not be free to rotate counter clockwisedue to the slotted arm 90.

FIGS. 10A and 10B illustrate two states of a variable sensor that may beused as the run motor sensor 110 according to various embodiments of thepresent invention. The sensor 110 may include a face portion 280, afirst electrode (A) 282, a second electrode (B) 284, and a compressibledielectric material 286 between the electrodes 282, 284, such as, forexample, an electroactive polymer (EAP). The sensor 110 may bepositioned such that the face portion 280 contacts the firing trigger 20when retracted. Accordingly, when the firing trigger 20 is retracted,the dielectric material 286 is compressed, as shown in FIG. 10B, suchthat the electrodes 282, 284 are closer together. Since the distance “b”between the electrodes 282, 284 is directly related to the impedancebetween the electrodes 282, 284, the greater the distance the moreimpedance, and the closer the distance the less impedance. In that way,the amount that the dielectric 286 is compressed due to retraction ofthe firing trigger 20 (denoted as force “F” in FIG. 42) is proportionalto the impedance between the electrodes 282, 284, which can be used toproportionally control the motor 65.

Components of an exemplary closure system for closing (or clamping) theanvil 24 of the end effector 12 by retracting the closure trigger 18 arealso shown in FIGS. 7-10. In the illustrated embodiment, the closuresystem includes a yoke 250 connected to the closure trigger 18 by apivot pin 251 inserted through aligned openings in both the closuretrigger 18 and the yoke 250. A pivot pin 252, about which the closuretrigger 18 pivots, is inserted through another opening in the closuretrigger 18 which is offset from where the pin 251 is inserted throughthe closure trigger 18. Thus, retraction of the closure trigger 18causes the upper part of the closure trigger 18, to which the yoke 250is attached via the pin 251, to rotate counterclockwise. The distal endof the yoke 250 is connected, via a pin 254, to a first closure bracket256. The first closure bracket 256 connects to a second closure bracket258. Collectively, the closure brackets 256, 258 define an opening inwhich the proximate end of the proximate closure tube 40 (see FIG. 4) isseated and held such that longitudinal movement of the closure brackets256, 258 causes longitudinal motion by the proximate closure tube 40.The instrument 10 also includes a closure rod 260 disposed inside theproximate closure tube 40. The closure rod 260 may include a window 261into which a post 263 on one of the handle exterior pieces, such asexterior lower side piece 59 in the illustrated embodiment, is disposedto fixedly connect the closure rod 260 to the handle 6. In that way, theproximate closure tube 40 is capable of moving longitudinally relativeto the closure rod 260. The closure rod 260 may also include a distalcollar 267 that fits into a cavity 269 in proximate spine tube 46 and isretained therein by a cap 271 (see FIG. 4).

In operation, when the yoke 250 rotates due to retraction of the closuretrigger 18, the closure brackets 256, 258 cause the proximate closuretube 40 to move distally (i.e., away from the handle end of theinstrument 10), which causes the distal closure tube 42 to movedistally, which causes the anvil 24 to rotate about the pivot pins 25into the clamped or closed position. When the closure trigger 18 isunlocked from the locked position, the proximate closure tube 40 iscaused to slide proximately, which causes the distal closure tube 42 toslide proximately, which, by virtue of the tab 27 being inserted in thewindow 45 of the distal closure tube 42, causes the anvil 24 to pivotabout the pivot pins 25 into the open or unclamped position. In thatway, by retracting and locking the closure trigger 18, an operator mayclamp tissue between the anvil 24 and channel 22, and may unclamp thetissue following the cutting/stapling operation by unlocking the closuretrigger 20 from the locked position.

FIG. 11 is a schematic diagram of an electrical circuit of theinstrument 10 according to various embodiments of the present invention.When an operator initially pulls in the firing trigger 20 after lockingthe closure trigger 18, the sensor 110 is activated, allowing current toflow therethrough. If the normally-open reverse motor sensor switch 130is open (meaning the end of the end effector stroke has not beenreached), current will flow to a single pole, double throw relay 132.Since the reverse motor sensor switch 130 is not closed, the inductor134 of the relay 132 will not be energized, so the relay 132 will be inits non-energized state. The circuit also includes a cartridge lockoutsensor 136. If the end effector 12 includes a staple cartridge 34, thesensor 136 will be in the closed state, allowing current to flow.Otherwise, if the end effector 12 does not include a staple cartridge34, the sensor 136 will be open, thereby preventing the battery 64 frompowering the motor 65.

When the staple cartridge 34 is present, the sensor 136 is closed, whichenergizes a single pole, single throw relay 138. When the relay 138 isenergized, current flows through the relay 136, through the variableresistor sensor 110, and to the motor 65 via a double pole, double throwrelay 140, thereby powering the motor 65 and allowing it to rotate inthe forward direction.

When the end effector 12 reaches the end of its stroke, the reversemotor sensor 130 will be activated, thereby closing the switch 130 andenergizing the relay 134. This causes the relay 134 to assume itsenergized state (not shown in FIG. 11), which causes current to bypassthe cartridge lockout sensor 136 and variable resistor 110, and insteadcauses current to flow to both the normally-closed double pole, doublethrow relay 142 and back to the motor 65, but in a manner, via the relay140, that causes the motor 65 to reverse its rotational direction.

Because the stop motor sensor switch 142 is normally-closed, currentwill flow back to the relay 134 to keep it closed until the switch 142opens. When the knife 32 is fully retracted, the stop motor sensorswitch 142 is activated, causing the switch 142 to open, therebyremoving power from the motor 65.

In other embodiments, rather than a proportional-type sensor 110, anon-off type sensor could be used. In such embodiments, the rate ofrotation of the motor 65 would not be proportional to the force appliedby the operator. Rather, the motor 65 would generally rotate at aconstant rate. But the operator would still experience force feedbackbecause the firing trigger 20 is geared into the gear drive train.

FIG. 12 is a side-view of the handle 6 of a power-assist motorizedendocutter according to another embodiment. The embodiment of FIG. 12 issimilar to that of FIGS. 7-10 except that in the embodiment of FIG. 12,there is no slotted arm connected to the ring 84 threaded on the helicalgear drum 80. Instead, in the embodiment of FIG. 12, the ring 84includes a sensor portion 114 that moves with the ring 84 as the ring 84advances down (and back) on the helical gear drum 80. The sensor portion114 includes a notch 116. The reverse motor sensor 130 may be located atthe distal end of the notch 116 and the stop motor sensor 142 may belocated at the proximate end of the notch 116. As the ring 84 moves downthe helical gear drum 80 (and back), the sensor portion 114 moves withit. Further, as shown in FIG. 12, the middle piece 104 may have an arm118 that extends into the notch 12.

In operation, as an operator of the instrument 10 retracts the firingtrigger 20 toward the pistol grip 26, the run motor sensor 110 detectsthe motion and sends a signal to power the motor 65, which causes, amongother things, the helical gear drum 80 to rotate. As the helical geardrum 80 rotates, the ring 84 threaded on the helical gear drum 80advances (or retracts, depending on the rotation). Also, due to thepulling in of the firing trigger 20, the middle piece 104 is caused torotate counter clockwise with the firing trigger 20 due to the forwardmotion stop 107 that engages the firing trigger 20. The counterclockwise rotation of the middle piece 104 cause the arm 118 to rotatecounter clockwise with the sensor portion 114 of the ring 84 such thatthe arm 118 stays disposed in the notch 116. When the ring 84 reachesthe distal end of the helical gear drum 80, the arm 118 will contact andthereby trip the reverse motor sensor 130. Similarly, when the ring 84reaches the proximate end of the helical gear drum 80, the arm willcontact and thereby trip the stop motor sensor 142. Such actions mayreverse and stop the motor 65, respectively as described above.

FIG. 13 is a side-view of the handle 6 of a power-assist motorizedendocutter according to another embodiment. The embodiment of FIG. 13 issimilar to that of FIGS. 7-10 except that in the embodiment of FIG. 13,there is no slot in the arm 90. Instead, the ring 84 threaded on thehelical gear drum 80 includes a vertical channel 126. Instead of a slot,the arm 90 includes a post 128 that is disposed in the channel 126. Asthe helical gear drum 80 rotates, the ring 84 threaded on the helicalgear drum 80 advances (or retracts, depending on the rotation). The arm90 rotates counter clockwise as the ring 84 advances due to the post 128being disposed in the channel 126, as shown in FIG. 13.

Trigger Lock

As mentioned above, in using a two-stroke motorized instrument, theoperator first pulls back and locks the closure trigger 18. FIGS. 14 and15 show one embodiment of a way to lock the closure trigger 18 to thepistol grip portion 26 of the handle 6. In the illustrated embodiment,the pistol grip portion 26 includes a hook 150 that is biased to rotatecounter clockwise about a pivot point 151 by a torsion spring 152. Also,the closure trigger 18 includes a closure bar 154. As the operator drawsin the closure trigger 18, the closure bar 154 engages a sloped portion156 of the hook 150, thereby rotating the hook 150 upward (or clockwisein FIGS. 14-15) until the closure bar 154 completely passes the slopedportion 156 into a recessed notch 158 of the hook 150, which locks theclosure trigger 18 in place. The operator may release the closuretrigger 18 by pushing down on a slide button release 160 on the back oropposite side of the pistol grip portion 26. Pushing down the slidebutton release 160 rotates the hook 150 clockwise such that the closurebar 154 is released from the recessed notch 158.

FIG. 16 shows another closure trigger locking mechanism according tovarious embodiments. In the embodiment of FIG. 16, the closure trigger18 includes a wedge 160 having an arrow-head portion 161. The arrow-headportion 161 is biased downward (or clockwise) by a leaf spring 162. Thewedge 160 and leaf spring 162 may be made from, for example, moldedplastic. When the closure trigger 18 is retracted, the arrow-headportion 161 is inserted through an opening 164 in the pistol gripportion 26 of the handle 6. A lower chamfered surface 166 of thearrow-head portion 161 engages a lower sidewall 168 of the opening 164,forcing the arrow-head portion 161 to rotate counter clockwise.Eventually the lower chamfered surface 166 fully passes the lowersidewall 168, removing the counter clockwise force on the arrow-headportion 161, causing the lower sidewall 168 to slip into a lockedposition in a notch 170 behind the arrow-head portion 161.

To unlock the closure trigger 18, a user presses down on a button 172 onthe opposite side of the closure trigger 18, causing the arrow-headportion 161 to rotate counter clockwise and allowing the arrow-headportion 161 to slide out of the opening 164.

FIGS. 17-22 show a closure trigger locking mechanism according toanother embodiment. As shown in this embodiment, the closure trigger 18includes a flexible longitudinal arm 176 that includes a lateral pin 178extending therefrom. The arm 176 and pin 178 may be made from moldedplastic, for example. The pistol grip portion 26 of the handle 6includes an opening 180 with a laterally extending wedge 182 disposedtherein. When the closure trigger 18 is retracted, the pin 178 engagesthe wedge 182, and the pin 178 is forced downward (i.e., the arm 176 isrotated clockwise) by the lower surface 184 of the wedge 182, as shownin FIGS. 17 and 18. When the pin 178 fully passes the lower surface 184,the clockwise force on the arm 176 is removed, and the pin 178 isrotated counter clockwise such that the pin 178 comes to rest in a notch186 behind the wedge 182, as shown in FIG. 19, thereby locking theclosure trigger 18. The pin 178 is further held in place in the lockedposition by a flexible stop 188 extending from the wedge 184.

To unlock the closure trigger 18, the operator may further squeeze theclosure trigger 18, causing the pin 178 to engage a sloped backwall 190of the opening 180, forcing the pin 178 upward past the flexible stop188, as shown in FIGS. 20 and 21. The pin 178 is then free to travel outan upper channel 192 in the opening 180 such that the closure trigger 18is no longer locked to the pistol grip portion 26, as shown in FIG. 22.

FIGS. 23A-B show a universal joint (“u-joint”) 195. The second piece195-2 of the u-joint 195 rotates in a horizontal plane in which thefirst piece 195-1 lies. FIG. 23A shows the u-joint 195 in a linear(180°) orientation and FIG. 23B shows the u-joint 195 at approximately a150° orientation. The u-joint 195 may be used instead of the bevel gears52 a-c (see FIG. 4, for example) at the articulation point 14 of themain drive shaft assembly to articulate the end effector 12. FIGS. 24A-Bshow a torsion cable 197 that may be used in lieu of both the bevelgears 52 a-c and the u-joint 195 to realize articulation of the endeffector 12.

Motor-Driven Instrument with Gear Drive Assembly

FIGS. 25-31 illustrate another embodiment of a motorized, two-strokesurgical cutting and fastening instrument 10 with power assist accordingto another embodiment of the present invention. The embodiment of FIGS.25-31 is similar to that of FIGS. 7-10 except that instead of thehelical gear drum 80, the embodiment of FIGS. 25-31 includes analternative gear drive assembly. The embodiment of FIGS. 25-31 includesa gear box assembly 200 including a number of gears disposed in a frame201, wherein the gears are connected between the planetary gear 72 andthe pinion gear 124 at the proximate end of the drive shaft 48. Asexplained further below, the gear box assembly 200 provides feedback tothe user via the firing trigger 20 regarding the deployment and loadingforce of the end effector 12. Also, the user may provide power to thesystem via the gear box assembly 200 to assist the deployment of the endeffector 12. In that sense, like the embodiments described above, theembodiment of FIG. 25-31 is another power assist motorized instrument 10that provides feedback to the user regarding the loading forceexperienced by the instrument.

In the illustrated embodiment, the firing trigger 20 includes twopieces: a main body portion 202 and a stiffening portion 204. The mainbody portion 202 may be made of plastic, for example, and the stiffeningportion 204 may be made out of a more rigid material, such as metal. Inthe illustrated embodiment, the stiffening portion 204 is adjacent tothe main body portion 202, but according to other embodiments, thestiffening portion 204 could be disposed inside the main body portion202. A pivot pin 207 may be inserted through openings in the firingtrigger pieces 202, 204 and may be the point about which the firingtrigger 20 rotates. In addition, a spring 222 may bias the firingtrigger 20 to rotate in a counter clockwise direction. The spring 222may have a distal end connected to a pin 224 that is connected to thepieces 202, 204 of the firing trigger 20. The proximate end of thespring 222 may be connected to one of the handle exterior lower sidepieces 59, 60.

In the illustrated embodiment, both the main body portion 202 and thestiffening portion 204 includes gear portions 206, 208 (respectively) attheir upper end portions. The gear portions 206, 208 engage a gear inthe gear box assembly 200, as explained below, to drive the main driveshaft assembly and to provide feedback to the user regarding thedeployment of the end effector 12.

The gear box assembly 200 may include as shown, in the illustratedembodiment, six (6) gears. A first gear 210 of the gear box assembly 200engages the gear portions 206, 208 of the firing trigger 20. Inaddition, the first gear 210 engages a smaller second gear 212, thesmaller second gear 212 being coaxial with a large third gear 214. Thethird gear 214 engages a smaller fourth gear 216, the smaller fourthgear being coaxial with a fifth gear 218. The fifth gear 218 is a 90°bevel gear that engages a mating 90° bevel gear 220 (best shown in FIG.31) that is connected to the pinion gear 124 that drives the main driveshaft 48.

In operation, when the user retracts the firing trigger 20, a run motorsensor (not shown) is activated, which may provide a signal to the motor65 to rotate at a rate proportional to the extent or force with whichthe operator is retracting the firing trigger 20. This causes the motor65 to rotate at a speed proportional to the signal from the sensor. Thesensor is not shown for this embodiment, but it could be similar to therun motor sensor 110 described above. The sensor could be located in thehandle 6 such that it is depressed when the firing trigger 20 isretracted. Also, instead of a proportional-type sensor, an on/off typesensor may be used.

Rotation of the motor 65 causes the bevel gears 68, 70 to rotate, whichcauses the planetary gear 72 to rotate, which causes, via the driveshaft 76, the ring gear 122 to rotate. The ring gear 122 meshes with thepinion gear 124, which is connected to the main drive shaft 48. Thus,rotation of the pinion gear 124 drives the main drive shaft 48, whichcauses actuation of the cutting/stapling operation of the end effector12.

Forward rotation of the pinion gear 124 in turn causes the bevel gear220 to rotate, which causes, by way of the rest of the gears of the gearbox assembly 200, the first gear 210 to rotate. The first gear 210engages the gear portions 206, 208 of the firing trigger 20, therebycausing the firing trigger 20 to rotate counter clockwise when the motor65 provides forward drive for the end effector 12 (and to rotate counterclockwise when the motor 65 rotates in reverse to retract the endeffector 12). In that way, the user experiences feedback regardingloading force and deployment of the end effector 12 by way of the user'sgrip on the firing trigger 20. Thus, when the user retracts the firingtrigger 20, the operator will experience a resistance related to theload force experienced by the end effector 12. Similarly, when theoperator releases the firing trigger 20 after the cutting/staplingoperation so that it can return to its original position, the user willexperience a clockwise rotation force from the firing trigger 20 that isgenerally proportional to the reverse speed of the motor 65.

It should also be noted that in this embodiment the user can apply force(either in lieu of or in addition to the force from the motor 65) toactuate the main drive shaft assembly (and hence the cutting/staplingoperation of the end effector 12) through retracting the firing trigger20. That is, retracting the firing trigger 20 causes the gear portions206, 208 to rotate counter clockwise, which causes the gears of the gearbox assembly 200 to rotate, thereby causing the pinion gear 124 torotate, which causes the main drive shaft 48 to rotate.

Although not shown in FIGS. 25-31, the instrument 10 may further includereverse motor and stop motor sensors. As described above, the reversemotor and stop motor sensors may detect, respectively, the end of thecutting stroke (full deployment of the knife 32) and the end ofretraction operation (full retraction of the knife 32). A similarcircuit to that described above in connection with FIG. 11 may be usedto appropriately power the motor 65.

Firing Trigger with Upper and Lower Portion

FIGS. 32-36 illustrate a two-stroke, motorized surgical cutting andfastening instrument 10 with power assist according to anotherembodiment. The embodiment of FIGS. 32-36 is similar to that of FIGS.25-31 except that in the embodiment of FIGS. 32-36, the firing trigger20 includes a lower portion 228 and an upper portion 230. Both portions228, 230 are connected to and pivot about a pivot pin 207 that isdisposed through each portion 228, 230. The upper portion 230 includes agear portion 232 that engages the first gear 210 of the gear boxassembly 200. The spring 222 is connected to the upper portion 230 suchthat the upper portion is biased to rotate in the clockwise direction.The upper portion 230 may also include a lower arm 234 that contacts anupper surface of the lower portion 228 of the firing trigger 20 suchthat when the upper portion 230 is caused to rotate clockwise the lowerportion 228 also rotates clockwise, and when the lower portion 228rotates counter clockwise the upper portion 230 also rotates counterclockwise. Similarly, the lower portion 228 includes a rotational stop238 that engages a shoulder of the upper portion 230. In that way, whenthe upper portion 230 is caused to rotate counter clockwise the lowerportion 228 also rotates counter clockwise, and when the lower portion228 rotates clockwise the upper portion 230 also rotates clockwise.

The illustrated embodiment also includes the run motor sensor 110 thatcommunicates a signal to the motor 65 that, in various embodiments, maycause the motor 65 to rotate at a speed proportional to the forceapplied by the operator when retracting the firing trigger 20. Thesensor 110 may be, for example, a rheostat or some other variableresistance sensor, as explained herein. In addition, the instrument 10may include reverse motor sensor 130 that is tripped or switched whencontacted by a front face 242 of the upper portion 230 of the firingtrigger 20. When activated, the reverse motor sensor 130 sends a signalto the motor 65 to reverse direction. Also, the instrument 10 mayinclude a stop motor sensor 142 that is tripped or actuated whencontacted by the lower portion 228 of the firing trigger 20. Whenactivated, the stop motor sensor 142 sends a signal to stop the reverserotation of the motor 65.

In operation, when an operator retracts the closure trigger 18 into thelocked position, the firing trigger 20 is retracted slightly (throughmechanisms known in the art, including U.S. Pat. No. 6,978,921 toFrederick Shelton, IV et. at and U.S. Pat. No. 6,905,057 to Jeffery S.Swayze et. al, which are incorporated herein by reference) so that theuser can grasp the firing trigger 20 to initiate the cutting/staplingoperation, as shown in FIGS. 32 and 33. At that point, as shown in FIG.33, the gear portion 232 of the upper portion 230 of the firing trigger20 moves into engagement with the first gear 210 of the gear boxassembly 200. When the operator retracts the firing trigger 20,according to various embodiments, the firing trigger 20 may rotate asmall amount, such as five degrees, before tripping the run motor sensor110, as shown in FIG. 34. Activation of the sensor 110 causes the motor65 to forward rotate at a rate proportional to the retraction forceapplied by the operator. The forward rotation of the motor 65 causes, asdescribed above, the main drive shaft 48 to rotate, which causes theknife 32 in the end effector 12 to be deployed (i.e., begin traversingthe channel 22). Rotation of the pinion gear 124, which is connected tothe main drive shaft 48, causes the gears 210-220 in the gear boxassembly 200 to rotate. Since the first gear 210 is in engagement withthe gear portion 232 of the upper portion 230 of the firing trigger 20,the upper portion 232 is caused to rotate counter clockwise, whichcauses the lower portion 228 to also rotate counter clockwise.

When the knife 32 is fully deployed (i.e., at the end of the cuttingstroke), the front face 242 of the upper portion 230 trips the reversemotor sensor 130, which sends a signal to the motor 65 to reverserotational directional. This causes the main drive shaft assembly toreverse rotational direction to retract the knife 32. Reverse rotationof the main drive shaft assembly also causes the gears 210-220 in thegear box assembly to reverse direction, which causes the upper portion230 of the firing trigger 20 to rotate clockwise, which causes the lowerportion 228 of the firing trigger 20 to rotate clockwise until the lowerportion 228 trips or actuates the stop motor sensor 142 when the knife32 is fully retracted, which causes the motor 65 to stop. In that way,the user experiences feedback regarding deployment of the end effector12 by way of the user's grip on the firing trigger 20. Thus, when theuser retracts the firing trigger 20, the operator will experience aresistance related to the deployment of the end effector 12 and, inparticular, to the loading force experienced by the knife 32. Similarly,when the operator releases the firing trigger 20 after thecutting/stapling operation so that it can return to its originalposition, the user will experience a clockwise rotation force from thefiring trigger 20 that is generally proportional to the reverse speed ofthe motor 65.

It should also be noted that in this embodiment the user can apply force(either in lieu of or in addition to the force from the motor 65) toactuate the main drive shaft assembly (and hence the cutting/staplingoperation of the end effector 12) through retracting the firing trigger20. That is, retracting the firing trigger 20 causes the gear portion232 of the upper portion 230 to rotate counter clockwise, which causesthe gears of the gear box assembly 200 to rotate, thereby causing thepinion gear 124 to rotate, which causes the main drive shaft assembly torotate.

Mechanically-Actuated Endoscopic Instruments

The above-described embodiments employed power-assist user feedbacksystems, with or without adaptive control (e.g., using a sensor 110,130, and 142 outside of the closed loop system of the motor 65, geardrive train, and end effector 12) for a two-stroke, motorized surgicalcutting and fastening instrument. That is, force applied by the user inretracting the firing trigger 20 may be added to the force applied bythe motor 65 by virtue of the firing trigger 20 being geared into(either directly or indirectly) the gear drive train between the motor65 and the main drive shaft 48. In other embodiments of the presentinvention, the user may be provided with tactile feedback regarding theposition of the knife 32 in the end effector, but without having thefiring trigger 20 geared into the gear drive train. FIGS. 37-40illustrate a motorized surgical cutting and fastening instrument withsuch a tactile position feedback system.

In the illustrated embodiment of FIGS. 37-40, the firing trigger 20 mayhave a lower portion 228 and an upper portion 230, similar to theinstrument 10 shown in FIGS. 32-36. Unlike the embodiment of FIGS.32-36, however, the upper portion 230 does not have a gear portion thatmates with part of the gear drive train. Instead, the instrumentincludes a second motor 265 with a threaded rod 266 threaded therein.The threaded rod 266 reciprocates longitudinally in and out of the motor265 as the motor 265 rotates, depending on the direction of rotation.The instrument 10 also includes an encoder 268 that is responsive to therotations of the main drive shaft 48 for translating the incrementalangular motion of the main drive shaft 48 (or other component of themain drive assembly) into a corresponding series of digital signals, forexample. In the illustrated embodiment, the pinion gear 124 includes aproximate drive shaft 270 that connects to the encoder 268.

The instrument 10 also includes a control circuit (not shown), which maybe implemented using a microcontroller or some other type of integratedcircuit, that receives the digital signals from the encoder 268. Basedon the signals from the encoder 268, the control circuit may calculatethe stage of deployment of the knife 32 in the end effector 12. That is,the control circuit can calculate if the knife 32 is fully deployed,fully retracted, or at an intermittent stage. Based on the calculationof the stage of deployment of the end effector 12, the control circuitmay send a signal to the second motor 265 to control its rotation tothereby control the reciprocating movement of the threaded rod 266.

In operation, as shown in FIG. 37, when the closure trigger 18 is notlocked into the clamped position, the firing trigger 20 rotates awayfrom the pistol grip portion 26 of the handle 6 such that the front face242 of the upper portion 230 of the firing trigger 20 is not in contactwith the proximate end of the threaded rod 266. When the operatorretracts the closure trigger 18 and locks it in the clamped position,the firing trigger 20 rotates slightly towards the closure trigger 20 sothat the operator can grasp the firing trigger 20, as shown in FIG. 38.In this position, the front face 242 of the upper portion 230 contactsthe proximate end of the threaded rod 266.

As the user then retracts the firing trigger 20, after an initialrotational amount (e.g. 5 degrees of rotation) the run motor sensor 110may be activated such that, as explained above, the sensor 110 sends asignal to the motor 65 to cause it to rotate at a forward speedproportional to the amount of retraction force applied by the operatorto the firing trigger 20. Forward rotation of the motor 65 causes themain drive shaft 48 to rotate via the gear drive train, which causes theknife 32 and sled 33 to travel down the channel 22 and sever tissueclamped in the end effector 12. The control circuit receives the outputsignals from the encoder 268 regarding the incremental rotations of themain drive shaft assembly and sends a signal to the second motor 265 tocause the second motor 265 to rotate, which causes the threaded rod 266to retract into the motor 265. This allows the upper portion 230 of thefiring trigger 20 to rotate counter clockwise, which allows the lowerportion 228 of the firing trigger to also rotate counter clockwise. Inthat way, because the reciprocating movement of the threaded rod 266 isrelated to the rotations of the main drive shaft assembly, the operatorof the instrument 10, by way of his/her grip on the firing trigger 20,experiences tactile feedback as to the position of the end effector 12.The retraction force applied by the operator, however, does not directlyaffect the drive of the main drive shaft assembly because the firingtrigger 20 is not geared into the gear drive train in this embodiment.

By virtue of tracking the incremental rotations of the main drive shaftassembly via the output signals from the encoder 268, the controlcircuit can calculate when the knife 32 is fully deployed (i.e., fullyextended). At this point, the control circuit may send a signal to themotor 65 to reverse direction to cause retraction of the knife 32. Thereverse direction of the motor 65 causes the rotation of the main driveshaft assembly to reverse direction, which is also detected by theencoder 268. Based on the reverse rotation detected by the encoder 268,the control circuit sends a signal to the second motor 265 to cause itto reverse rotational direction such that the threaded rod 266 starts toextend longitudinally from the motor 265. This motion forces the upperportion 230 of the firing trigger 20 to rotate clockwise, which causesthe lower portion 228 to rotate clockwise. In that way, the operator mayexperience a clockwise force from the firing trigger 20, which providesfeedback to the operator as to the retraction position of the knife 32in the end effector 12. The control circuit can determine when the knife32 is fully retracted. At this point, the control circuit may send asignal to the motor 65 to stop rotation.

According to other embodiments, rather than having the control circuitdetermine the position of the knife 32, reverse motor and stop motorsensors may be used, as described above. In addition, rather than usinga proportional sensor 110 to control the rotation of the motor 65, anon/off switch or sensor can be used. In such an embodiment, the operatorwould not be able to control the rate of rotation of the motor 65.Rather, it would rotate at a preprogrammed rate.

End Effector of Mechanically Actuated Instrument

FIGS. 41-43 illustrate an exemplary embodiment of a mechanicallyactuated endocutter, and in particular the handle 6, shaft 8 and endeffector 12 thereof. Further details of a mechanically actuatedendocutter may be found in U.S. patent application Ser. No. 11/052,632entitled, “Surgical Stapling Instrument Incorporating A Multi-StrokeFiring Mechanism With Automatic End Of Firing Travel Retraction,” whichis incorporated herein by reference. With reference to FIG. 41, the endeffector 12 responds to the closure motion from the handle 6 (notdepicted in FIG. 41) first by including an anvil face 1002 connecting toan anvil proximal end 1004 that includes laterally projecting anvilpivot pins 25 that are proximal to a vertically projecting anvil tab 27.The anvil pivot pins 25 translate within kidney shaped openings 1006 inthe staple channel 22 to open and close anvil 24 relative to channel 22.The tab 27 engages a bent tab 1007 extending inwardly in tab opening 45on a distal end 1008 of the closure tube 1005, the latter distallyterminating in a distal edge 1008 that pushes against the anvil face1002. Thus, when the closure tube 1005 moves proximally from its openposition, the bent tab 1007 of the closure tube 1005 draws the anvil tab27 proximally, and the anvil pivot pins 25 follow the kidney shapedopenings 1006 of the staple channel 22 causing the anvil 24 tosimultaneously translate proximally and rotate upward to the openposition. When the closure tube 1005 moves distally, the bent tab 1007in the tab opening 45 releases from the anvil tab 27 and the distal edge1008 pushes on the anvil face 1002, closing the anvil 24.

With continued reference to FIG. 41, the shaft 8 and end effector 12also include components that respond to a firing motion of a firing rod1010. In particular, the firing rod 1010 rotatably engages a firingtrough member 1012 having a longitudinal recess 1014. Firing troughmember 1012 moves longitudinally within frame 1016 in direct response tolongitudinal motion of firing rod 1010. A longitudinal slot 1018 in theclosure tube 1005 operably couples with the right and left exterior sidehandle pieces 61, 62 of the handle 6 (not shown in FIG. 41). The lengthof the longitudinal slot 1018 in the closure tube 1005 is sufficientlylong to allow relative longitudinal motion with the handle pieces 61, 62to accomplish firing and closure motions respectively with the couplingof the handle pieces 61, 62 passing on through a longitudinal slot 1020in the frame 1016 to slidingly engage the longitudinal recess 1014 inthe frame trough member 1012.

The distal end of the frame trough member 1012 is attached to a proximalend of a firing bar 1022 that moves within the frame 1016, specificallywithin a guide 1024 therein, to distally project the knife 32 into theend effector 12. The end effector 12 includes a staple cartridge 34 thatis actuated by the knife 32. The staple cartridge 34 has a tray 1028that holds a staple cartridge body 1030, a wedge sled driver 33, stapledrivers 1034 and staples 1036. It will be appreciated that the wedgesled driver 33 longitudinally moves within a firing recess (not shown)located between the cartridge tray 1028 and the cartridge body 1030. Thewedge sled driver 33 presents camming surfaces that contact and lift thestaple drivers 1034 upward, driving the staples 1036. The staplecartridge body 1030 further includes a proximally open, vertical slot1031 for passage of the knife 32. Specifically, a cutting surface 1027is provided along a distal end of knife 32 to cut tissue after it isstapled.

It should be appreciated that the shaft 8 is shown in FIG. 4 as anon-articulating shaft. Nonetheless, applications of the presentinvention may include instruments capable of articulation, for example,as such shown above with reference to FIGS. 1-4 and described in thefollowing U.S. patents and patent applications, the disclosure of eachbeing hereby incorporated by reference in their entirety: (1) SURGICALINSTRUMENT INCORPORATING AN ARTICULATION MECHANISM HAVING ROTATION ABOUTTHE LONGITUDINAL AXIS, U.S. Pat. No. 7,111,769, to Frederick E. SheltonIV, Brian J. Hemmelgarn, Jeffrey S. Swayze, Kenneth S. Wales; (2)SURGICAL STAPLING INSTRUMENT INCORPORATING AN ARTICULATION JOINT FOR AFIRING BAR TRACK, U.S. Pat. No. 6,786,382, to Brian J. Hemmelgarn; (3) ASURGICAL INSTRUMENT WITH A LATERAL-MOVING ARTICULATION CONTROL, U.S.Pat. No. 6,981,628, to Jeffrey S. Swayze; (4) SURGICAL STAPLINGINSTRUMENT INCORPORATING A TAPERED FIRING BAR FOR INCREASED FLEXIBILITYAROUND THE ARTICULATION JOINT, U.S. Pat. No. 6,964,363, to Frederick E.Shelton IV, Michael Setser, Bruce Weisenburgh II; and (5) SURGICALSTAPLING INSTRUMENT HAVING ARTICULATION JOINT SUPPORT PLATES FORSUPPORTING A FIRING BAR, U.S. Patent Application Publication No.2005/0006431, by Jeffrey S. Swayze, Joseph Charles Hueil, filed 9 Jul.2003.

Handle of Mechanically Actuated Instrument

FIGS. 42-43 show an embodiment of the handle 6 that is configured foruse in a mechanically actuated endocutter along with the embodiment ofthe shaft 8 and end effector 12 as shown above in FIG. 41. It will beappreciated that any suitable handle design may be used to mechanicallyclose and fire the end effector 12. In FIGS. 42-43, the handle 6 of thesurgical stapling and severing instrument 10 includes a linkedtransmission firing mechanism 1060 that provides features such asincreased strength, reduced handle size, minimized binding, etc.

Closure of the end effector 12 (not shown in FIGS. 42-43) is caused bydepressing the closure trigger 18 toward the pistol grip 26 of handle 6.The closure trigger 18 pivots about a closure pivot pin 252 that iscoupled to right and left exterior lower side pieces 59, 60 the handle6, causing an upper portion 1094 of the closure trigger 18 to moveforward. The closure tube 1005 receives this closure movement via theclosure yoke 250 that is pinned to a closure link 1042 and to the upperportion 1094 of the closure trigger 18 respectively by a closure yokepin 1044 and a closure link pin 1046.

In the fully open position of FIG. 42, the upper portion 1094 of theclosure trigger 18 contacts and holds a locking arm 1048 of the pivotingclosure release button 30 in the position shown. When the closuretrigger 18 reaches its fully depressed position, the closure trigger 18releases the locking arm 1048 and an abutting surface 1050 rotates intoengagement with a distal rightward notch 1052 of the pivoting lockingarm 1048, holding the closure trigger 18 in this clamped or closedposition. A proximal end of the locking arm 1048 pivots about a lateralpivotal connection 1054 with the pieces 59, 60 to expose the closurerelease button 30. An intermediate, distal side 1056 of the closurerelease button 30 is urged proximally by a compression spring 1058,which is compressed between a housing structure 1040 and closure releasebutton 30. The result is that the closure release button 30 urges thelocking arm 1048 counterclockwise (when viewed from the left) intolocking contact with the abutting surface 1050 of closure trigger 18,which prevents unclamping of closure trigger 18 when the linkedtransmission firing system 1040 is in an un-retracted condition.

With the closure trigger 18 retracted and fully depressed, the firingtrigger 20 is unlocked and may be depressed toward the pistol grip 26,multiple times in this embodiment, to effect firing of the end effector12. As depicted, the linked transmission firing mechanism 1060 isinitially retracted, urged to remain in this position by a combinationtension/compression spring 1062 that is constrained within the pistolgrip 26 of the handle 6, with its nonmoving end 1063 connected to thepieces 59, 60 and a moving end 1064 connected to a downwardly flexed andproximal, retracted end 1067 of a steel band 1066.

A distally-disposed end 1068 of the steel band 1066 is attached to alink coupling 1070 for structural loading, which in turn is attached toa front link 1072 a of a plurality of links 1072 a-1072 d that form alinked rack 1074. Linked rack 1074 is flexible yet has distal links thatform a straight rigid rack assembly that may transfer a significantfiring force through the firing rod 1010 in the shaft 6, yet readilyretract into the pistol grip 26 to minimize the longitudinal length ofthe handle 6. It should be appreciated that the combinationtension/compression spring 1062 increases the amount of firing travelavailable while essentially reducing the minimum length by half over asingle spring.

The firing trigger 20 pivots about a firing trigger pin 96 that isconnected to the handle pieces 59, 60. An upper portion 228 of thefiring trigger 20 moves distally about the firing trigger pin 96 as thefiring trigger 20 is depressed towards pistol grip 26, stretching aproximally placed firing trigger tension spring 222 proximally connectedbetween the upper portion 228 of the firing trigger 20 and the pieces59, 60. The upper portion 228 of the firing trigger 20 engages thelinked rack 1074 during each firing trigger depression by a tractionbiasing mechanism 1078 that also disengages when the firing trigger 20is released. Firing trigger tension spring 222 urges the firing trigger20 distally when released and disengages the traction biasing mechanism1078.

As the linked transmission firing mechanism 1040 actuates, an idler gear1080 is rotated clockwise (as viewed from the left side) by engagementwith a toothed upper surface 1082 of the linked rack 1074. This rotationis coupled to an indicator gear 1084, which thus rotatescounterclockwise in response to the idler gear 1080. Both the idler gear1080 and indicator gear 1084 are rotatably connected to the pieces 59,60 of the handle 6. The gear relationship between the linked rack 1074,idler gear 1080 and indicator gear 1084 may be advantageously selectedso that the toothed upper surface 1082 has tooth dimensions that aresuitably strong and that the indicator gear 1084 makes no more than onerevolution during the full firing travel of the linked transmissionfiring mechanism 1060.

Indicator Gear of Mechanically Actuated Instrument

As described in greater detail below, the indicator gear 1084 performsat least four functions. First, when the linked rack 1074 is fullyretracted and both triggers 18, 20 are open as shown in FIG. 42, anopening 1086 in a circular ridge 1088 on the left side of the indicatorgear 1084 is presented to an upper surface 1090 of the locking arm 1048.Locking arm 1048 is biased into the opening 1086 by contact with theclosure trigger 18, which in turn is urged to the open position by aclosure tension spring 1092. Closure trigger tension spring 1092 isconnected proximally to the upper portion 1094 of the closure trigger 18and the handle pieces 59, 60, and thus has energy stored during closingof the closure trigger 18 that urges the closure trigger 18 distally toits unclosed position.

A second function of the indicator gear 1084 is that it is connected tothe indicating retraction knob 1096 externally disposed on the handle 6.Thus, the indicator gear 1084 communicates the relative position of thefiring mechanism 1060 to the indicating retraction knob 1096 so that thesurgeon has a visual indication of how many strokes of the firingtrigger 20 are required to complete firing.

A third function of the indicator gear 1084 is to longitudinally andangularly move an anti-backup release lever 1098 of an anti-backupmechanism (one-way clutch mechanism) 1097 as the surgical stapling andsevering instrument 10 is operated. During the firing strokes, proximalmovement of anti-backup release lever 1098 by indicator gear 1084activates the anti-backup mechanism 1097 that allows distal movement offiring bar 1010 and prevents proximal motion of firing bar 1010. Thismovement also extends the anti-backup release button 1100 from theproximal end of the handle pieces 59, 60 for the operator to actuateshould the need arise for the linked transmission firing mechanism 1060to be retracted during the firing strokes. After completion of thefiring strokes, the indicator gear 1084 reverses direction of rotationas the firing mechanism 1060 retracts. The reversed rotation deactivatesthe anti-backup mechanism 1097, withdraws the anti-backup release button1100 into the handle 6, and rotates the anti-backup release lever 1098laterally to the right to allow continued reverse rotation of theindicator gear 1084.

A fourth function of the indicator gear 1084 is to receive a manualrotation from the indicating retraction knob 1096 (clockwise in thedepiction of FIG. 42) to retract the firing mechanism 1060 withanti-backup mechanism 1097 unlocked, thereby overcoming any binding inthe firing mechanism 1060 that is not readily overcome by thecombination tension/compression spring 1062. This manual retractionassistance may be employed after a partial firing of the firingmechanism 1060 that would otherwise be prevented by the anti-backupmechanism 1097 that withdraws the anti-backup release button 1100 sothat the latter may not laterally move the anti-backup release lever1098.

Continuing with FIGS. 42-43, anti-backup mechanism 1097 consists of theoperator accessible anti-backup release lever 1098 operably coupled atthe proximal end to the anti-backup release button 1100 and at thedistal end to an anti-backup yoke 1102. In particular, a distal end 1099of the anti-backup release lever 1098 is engaged to the anti-backup yoke1102 by an anti-backup yoke pin 1104. The anti-backup yoke 1102 moveslongitudinally to impart a rotation to an anti-backup cam slot tube 1106that is longitudinally constrained by the handle pieces 59, 90 and thatencompasses the firing rod 1010 distally to the connection of the firingrod 1010 to the link coupling 1070 of the linked rack 1074. Theanti-backup yoke 1102 communicates the longitudinal movement from theanti-backup release lever 1098 via a cam slot tube pin 1108 to theanti-backup cam slot tube 1106. That is, longitudinal movement of camslot tube pin 1108 in an angled slot in the anti-backup cam slot tube1106 rotates the anti-backup cam slot tube 1106.

Trapped between a proximal end of the frame 1016 and the anti-backup camslot tube 1106 respectively are an anti-backup compression spring 1110,an anti-backup plate 1112, and an anti-backup cam tube 1114. Asdepicted, proximal movement of the firing rod 1010 causes theanti-backup plate 1112 to pivot top to the rear, presenting an increasedfrictional contact to the firing rod 1010 that resists further proximalmovement of the firing rod 1010.

This anti-backup plate 1112 pivots in a manner similar to that of ascreen door lock that holds open a screen door when the anti-backup camslot tube 1106 is closely spaced to the anti-backup cam tube 1114.Specifically, the anti-backup compression spring 1110 is able to actupon a top surface of the plate 1112 to tip the anti-backup plate 1112to its locked position. Rotation of the anti-backup cam slot tube 1106causes a distal camming movement of the anti-backup cam tube 1114thereby forcing the top of the anti-backup plate 1112 distally,overcoming the force from the anti-backup compression spring 1110, thuspositioning the anti-backup plate 1112 in an untipped (perpendicular),unlocked position that allows proximal retraction of the firing rod1010.

With particular reference to FIG. 43, the traction biasing mechanism1078 is depicted as being composed of a pawl 1116 that has a distallyprojecting narrow tip 1118 and a rightwardly projecting lateral pin 1120at its proximal end that is rotatably inserted through a hole 1076 inthe upper portion 230 of the firing trigger 20. On the right side of thefiring trigger 20 the lateral pin 1120 receives a biasing member,depicted as biasing wheel 1122. As the firing trigger 20 translates foreand aft, the biasing wheel 1122 traverses an arc proximate to the righthalf piece 59 of the handle 6, overrunning at its distal portion oftravel a biasing ramp 1124 integrally formed in the right half piece 59.The biasing wheel 1122 may advantageously be formed from a resilient,frictional material that induces a counterclockwise rotation (whenviewed from the left) into the lateral pin 1120 of the pawl 1116, thustraction biasing the distally projecting narrow tip 1118 downward into aramped central track 1075 of the nearest link 1072 a-d to engage thelinked rack 1074.

As the firing trigger 20 is released, the biasing wheel 1122 thustractionally biases the pawl 1116 in the opposite direction, raising thenarrow tip 1118 from the ramped central track 1075 of the linked rack1074. To ensure disengagement of the tip 1118 under high load conditionsand at nearly full distal travel of the pawl 1116, the right side of thepawl 1116 ramps up onto a proximally and upwardly facing beveled surface1126 on the rightside of the closure yoke 250 to disengage the narrowtip 1118 from the ramped central track 1075. If the firing trigger 20 isreleased at any point other than full travel, the biasing wheel 1122 isused to lift the narrow tip 1118 from the ramped central track 1075.Whereas a biasing wheel 1122 is depicted, it should be appreciated thatthe shape of the biasing member or wheel 1122 is illustrative and may bevaried to accommodate a variety of shapes that use friction or tractionto engage or disengage the firing of the end effector 12.

Sensing and Recording Instrument Conditions

Various embodiments of the surgical instrument 10 have the capability torecord instrument conditions at one or more times during use. FIG. 44shows a block diagram of a system 2000 for recording conditions of theinstrument 10. It will be appreciated that the system 2000 may beimplemented in embodiments of the instrument 10 having motorized ormotor-assisted firing, for example, as described above with reference toFIGS. 1-40, as well as embodiments of the instrument 10 havingmechanically actuated firing, for example, as described above withreference to FIGS. 41-43.

The system 2000 may include various sensors 2002, 2004, 2006, 2008,2010, 2012 for sensing instrument conditions. The sensors may bepositioned, for example, on or within the instrument 10. In variousembodiments, the sensors may be dedicated sensors that provide outputonly for the system 2000, or may be dual-use sensors that perform otherfunctions in the instrument 10. For example, sensors 110, 130, 142described above may be configured to also provide output to the system2000.

Directly or indirectly, each sensor provides a signal to the memorydevice 2001, which records the signals as described in more detailbelow. The memory device 2001 may be any kind of device capable ofstoring or recording sensor signals. For example, the memory device 2001may include a microprocessor, an Electrically Erasable Programmable ReadOnly Memory (EEPROM), or any other suitable storage device. The memorydevice 2001 may record the signals provided by the sensors in anysuitable way. For example, in one embodiment, the memory device 2001 mayrecord the signal from a particular sensor when that signal changesstates. In another embodiment, the memory device 2001 may record a stateof the system 2000, e.g., the signals from all of the sensors includedin the system 2000, when the signal from any sensor changes states. Thismay provide a snap-shot of the state of the instrument 10. In variousembodiments, the memory device 2001 and/or sensors may be implemented toinclude 1-WIRE bus products available from DALLAS SEMICONDUCTOR such as,for example, a 1-WIRE EEPROM.

In various embodiments, the memory device 2001 is externally accessible,allowing an outside device, such as a computer, to access the instrumentconditions recorded by the memory device 2001. For example, the memorydevice 2001 may include a data port 2020. The data port 2020 may providethe stored instrument conditions according to any wired or wirelesscommunication protocol in, for example, serial or parallel format. Thememory device 2001 may also include a removable medium 2021 in additionto or instead of the output port 2020. The removable medium 2021 may beany kind of suitable data storage device that can be removed from theinstrument 10. For example, the removable medium 2021 may include anysuitable kind of flash memory, such as a Personal Computer Memory CardInternational Association (PCMCIA) card, a COMPACTFLASH card, aMULTIMEDIA card, a FLASHMEDIA card, etc. The removable medium 2021 mayalso include any suitable kind of disk-based storage including, forexample, a portable hard drive, a compact disk (CD), a digital videodisk (DVD), etc.

The closure trigger sensor 2002 senses a condition of the closuretrigger 18. FIGS. 45 and 46 show an exemplary embodiment of the closuretrigger sensor 2002. In FIGS. 45 and 46, the closure trigger sensor 2002is positioned between the closure trigger 18 and closure pivot pin 252.It will be appreciated that pulling the closure trigger 18 toward thepistol grip 26 causes the closure trigger 18 to exert a force on theclosure pivot pin 252. The sensor 2002 may be sensitive to this force,and generate a signal in response thereto, for example, as describedabove with respect to sensor 110 and FIGS. 10A and 10B. In variousembodiments, the closure trigger sensor 2002 may be a digital sensorthat indicates only whether the closure trigger 18 is actuated or notactuated. In other various embodiments, the closure trigger sensor 2002may be an analog sensor that indicates the force exerted on the closuretrigger 18 and/or the position of the closure trigger 18. If the closuretrigger sensor 2002 is an analog sensor, an analog-to-digital convertermay be logically positioned between the sensor 2002 and the memorydevice 2001. Also, it will be appreciated that the closure triggersensor 2002 may take any suitable form and be placed at any suitablelocation that allows sensing of the condition of the closure trigger.

The anvil closure sensor 2004 may sense whether the anvil 24 is closed.FIG. 47 shows an exemplary anvil closure sensor 2004. The sensor 2004 ispositioned next to, or within the kidney shaped openings 1006 of thestaple channel 22 as shown. As the anvil 24 is closed, anvil pivot pins25 slides through the kidney shaped openings 1006 and into contact withthe sensor 2004, causing the sensor 2004 to generate a signal indicatingthat the anvil 24 is closed. The sensor 2004 may be any suitable kind ofdigital or analog sensor including a proximity sensor, etc. It will beappreciated that when the anvil closure sensor 2004 is an analog sensor,an analog-to-digital converter may be included logically between thesensor 2004 and the memory device 2001.

Anvil closure load sensor 2006 is shown placed on an inside bottomsurface of the staple channel 22. In use, the sensor 2006 may be incontact with a bottom side of the staple cartridge 34 (not shown in FIG.46). As the anvil 24 is closed, it exerts a force on the staplecartridge 34 which is transferred to the sensor 2006. In response, thesensor 2006 generates a signal. The signal may be an analog signalproportional to the force exerted on the sensor 2006 by the staplecartridge 34 and due to the closing of the anvil 24. Referring the FIG.44, the analog signal may be provided to an analog-to-digital converter2014, which converts the analog signal to a digital signal beforeproviding it to the memory device 2001. It will be appreciated thatembodiments where the sensor 2006 is a digital or binary sensor may notinclude analog-to-digital converter 2014.

The firing trigger sensor 110 senses the position and/or state of thefiring trigger 20. In motorized or motor-assisted embodiments of theinstrument, the firing trigger sensor may double as the run motor sensor110 described above. In addition, the firing trigger sensor 110 may takeany of the forms described above, and may be analog or digital. FIGS. 45and 46 show an additional embodiment of the firing trigger sensor 110.In FIGS. 45 and 46, the firing trigger sensor is mounted between firingtrigger 20 and firing trigger pivot pin 96. When firing trigger 20 ispulled, it will exert a force on firing trigger pivot pin 96 that issensed by the sensor 110. Referring to FIG. 44, in embodiments where theoutput of the firing trigger sensor 110 is analog, analog-to-digitalconverter 2016 is included logically between the firing trigger sensor110 and the memory device 2001.

FIGS. 47A, 48 and 49 show embodiments of a knife position sensor 2008.The knife position sensor 2008 senses the position of the knife 32 orcutting surface 1027 within the staple channel 22. In a firstembodiment, referring to FIGS. 48 and 49, the sensor 2008 includes amagnet 2009 that is coupled to or otherwise supported by a portion ofthe firing bar 1022 of the instrument 10. A coil 2011 is supportedwithin a longitudinal recess 1014 in the firing trough member 1012 (seeFIG. 41) and is so positioned to permit the firing bar to reciprocatetherein. As the knife 32 and cutting surface 1027 are reciprocatedthrough the staple channel 22, the firing bar 1022 and magnet 2009 maymove back and forth through the coil 2011. This motion relative to thecoil 2011 induces a voltage in the coil 2011 that is indicative of theposition of the firing bar 1022 within the coil 2011 and which is alsoindicative of the position of the cutting edge 1027 within the staplechannel 22. This voltage may be provided to the memory device 2001, forexample, via analog-to-digital converter 2018.

In another embodiment, referring to FIG. 47A, the knife position sensor2008 includes a plurality of Hall Effect transducers 2030 a, 2030 b onthe interior surface 2040 of the staple channel 22. Although not shownin FIG. 47A, the cartridge tray 1028 (FIG. 41) may be provided withopenings therein that correspond to the transducers 2030 a, 2030 b. Aspreviously described in connection with other embodiments, a slot 2044extends through the interior surface 2040 along a portion of the staplechannel 22. A sled 33 with a knife 32 and a magnetic element 2009 a maybe coupled to or otherwise supported by a distal end of the firing bar1022; the sled is configured to translate along the slot 2044. The firstHall Effect transducer 2030 a may be positioned proximate to thetranslatable magnetic element 2009 a and the second Hall Effecttransducer 2030 b may be positioned distal to the translatable magneticelement 2009 a. The Hall Effect transducers 2030 a, 2030 b produce avoltage in response to the magnetic field produced by the magneticelement 2046. As the sled 33 translates along the slot 2044, themagnetic element 2009 a moves between the Hall Effect transducers 2030a, 2030 b. Movement of the magnetic element 2009 a changes the voltageacross the Hall Effect transducers 2030 a, 2030 b; the position of themagnetic element 2009 a, and by extension, the position of the knife 32,can be determined by the change in voltage across multiple Hall Effecttransducers 2030 a, 2030 b. In another embodiment, the knife positionsensor 2008 may have additional Hall Effect transducers 2030 on theinterior surface 2040 of the cartridge tray 1028.

In various embodiments, the knife position sensor 2008 may instead beimplemented as a series of digital sensors (not shown) placed at variouspositions on or within the shaft 8. The digital sensors may sense afeature of the firing bar 1022 such as, for example, magnet 2009, as thefeature reciprocates through the shaft 8. The position of the firing bar1022 within the shaft 8, and by extension, the position of the knife 32within the staple channel 22, may be approximated as the position of thelast digital sensor tripped.

The voltage from the knife position sensor 2008 may be provided to thememory device 2001, for example, via an analog-to-digital converter2018. In various embodiments, output voltage from the Hall Effecttransducers 2030 may first be transmitted to an integrated circuit (notshown) for amplification of the voltage signal. Further, the outputvoltage may be encoded and/or modulated according to a modulationscheme. The output voltage may be provided to the memory device 2001 bya wired communication. Referring to FIG. 47A, insulated wires or similarconductors 2050 may transmit an electrical signal indicative of thevoltage from the Hall Effect transducers 2030 a, 2030 b to the memorydevice 2001. The wires 2050 may be made of an electrically conductivepolymer and/or metal (e.g. copper) and may be sufficiently flexible tocould pass through an articulation pivot 14 and not be damaged byarticulation.

In another embodiment, the signal may be wirelessly transmitted to thememory device 2001. Various wireless communication embodiments aredescribed in U.S. patent application Ser. No. 13/118,259 to James R.Giordano et al. filed on May 27, 2011, the disclosure of which is hereinincorporated by reference in its entirety. To wirelessly transmit thesignal, the Hall Effect transducers 2030 may comprise an inductiveelement 2052 that acts as a transmitting antenna. The inductive element2052 may both transmit signals from the Hall Effect transducers 2030 andreceive power from a power source, such as a battery, external orinternal to the surgical instrument 10. The inductive element 2052 ofthe Hall Effect transducers 2030 is preferably insulated from theelectrically conductive outer shaft 8 of the instrument 10.

In another embodiment, the inductive element 2052 may comprisecomponents of the end effector 12 and shaft 8. In such an embodiment,the Hall Effect transducers 2030 are electrically connected to the shaft8 and the memory device is insulated from the shaft. For example, theinterior surface 2040 of the cartridge tray 1028 may comprise aconductive material, which in turn may be electrically coupled toconductive elements of the shaft 8 (such as closure tubes 40, 42) byeither direct or indirect electrical contact. The shaft 8 may begrounded by the exterior lower and upper side pieces 59-62, which may bemade of non-electrically conductive material, such as plastic.Additional components of the end effector 12 may comprise non-conductivematerial and the memory device 2001 is insulated from the shaft 8. Thecomponents of the end effector 12 and shaft 8 electrically connected tothe inductive element 2052 of the sensor 2008 may serve as part of anantenna for transmitting signals indicative of voltage from the HallEffect transducers 2030 to the memory device 2001. Alternatively, thememory device 2001 may be in electrical communication with selectcomponents of the end effector 12 and shaft 8 and the Hall Effecttransducers may be insulated. The select components of the end effector12 and shaft electrically connected to the memory device 2001 may serveas part of an antenna for receiving signals from the sensor 2008. Thetransducers 2030 may be insulated by positioning them in a cartridgetray 1028, which is made of a non-electrically conductive material, suchas plastic.

The instrument may comprise multiple inductive elements for transmittingsignals from the Hall Effect transducers 2030 to the memory device 2001.For example, transducers 2030 may transmit a signal to an intermediateinductive element 2054. Such an intermediate inductive element 2054could be located, for example, along the shaft 8 or handle 6 of theinstrument 10. An intermediate inductive element 2054 a may then relaythe signal to another intermediate inductive element 2054 b or to thememory device 2001. If more inductive couplings are in place between theHall Effect transducers 2030 and the memory device, the distance betweenthe inductive elements is reduced and a weaker signal may be utilized totransmit the signal. Alternatively, if fewer inductive couplings are inplace, a stronger signal may be required due to the greater transmissiondistances. Because the distances between the inductive elements arefixed and known, the power levels could be optimized for low levels tothereby minimize interference with other systems in the environment ofthe instrument 10.

Alternatively, a combination of wired and wireless connections could beutilized to transmit signals from the Hall Effect transducers 2030 tothe memory device 2001. For example, referring to FIG. 172, the endeffector 12 may include a wire 2050 that connects a Hall Effecttransducer 2030 a to an intermediate inductive element 2054 a on theshaft 6 of the instrument. The signal may be wireless transmitted from adistal intermediate inductive element 2054 a to a proximal intermediateinductive element 2054 b. The proximal intermediate inductive element2054 b may transmit the signal to an antenna on the memory device 2001via a conductive wire or wirelessly.

The knife position sensor 2008 may communicate with the memory deviceusing any suitable frequency (e.g., an ISM band). Also, the sensor 2008may transmit signals at a different frequency range than the frequencyrange of the received signals from the memory device 2001. Also, thoughonly one antenna is discussed above with regard to the knife positionsensor 2008, in other embodiments the sensor 2008 may comprisingseparate receiving and transmitting antennas.

The signals indicative of voltage may be demodulated and/or decoded bythe memory device 2001. The memory device 2001 may also compute theposition of the knife from the output voltage. Upon determining theposition of the knife in the elongate channel, the position may becommunicated to a visual indication screen (not shown) viewable by theuser. Additionally or alternatively, the voltage may be communicated tothe user by a haptic indication. For example, as the knife 33 reachesthe end of the slot 2044 in the staple channel 22, the user may bealerted by increased resistance from the firing trigger 20.

It will be appreciated that the knife position may also be sensed inembodiments of the instrument 10 having a rotary driven end effector 12and shaft 8, for example, as described above, with reference to FIGS.3-6. An encoder, such as encoder 268, may be configured to generate asignal proportional to the rotation of the helical screw shaft 36, orany other drive shaft or gear. Because the rotation of the shaft 36 andother drive shafts and gears is proportional to the movement of theknife 32 through the channel 22, the signal generated by the encoder 268is also proportional to the movement of the knife 32. Thus, the outputof the encoder 268 may be provided to the memory device 2001.

The cartridge present sensor 2010 may sense the presence of the staplecartridge 34 within the staple channel 22. In motorized ormotor-assisted instruments, the cartridge present sensor 2010 may doubleas the cartridge lock-out sensor 136 described above with reference toFIG. 11. FIGS. 50 and 51 show an embodiment of the cartridge presentsensor 2010. In the embodiment shown, the cartridge present sensor 2010includes two contacts, 2011 and 2013. When no cartridge 34 is present,the contacts 2011, 2013 form an open circuit. When a cartridge 34 ispresent, the cartridge tray 1028 of the staple cartridge 34 contacts thecontacts 2011, 2013, a closed circuit is formed. When the circuit isopen, the sensor 2010 may output a logic zero. When the circuit isclosed, the sensor 2010 may output a logic one. The output of the sensor2010 is provided to memory device 2001, as shown in FIG. 44.

The cartridge condition sensor 2012 may indicate whether a cartridge 34installed within the staple channel 22 has been fired or spent. As theknife 32 is translated through the end effector 12, it pushes the sled33, which fires the staple cartridge. Then the knife 32 is translatedback to its original position, leaving the sled 33 at the distal end ofthe cartridge. Without the sled 33 to guide it, the knife 32 may fallinto lock-out pocket 2022. Sensor 2012 may sense whether the knife 32 ispresent in the lock-out pocket 2022, which indirectly indicates whetherthe cartridge 34 has been spent. It will be appreciated that in variousembodiments, sensor 2012 may directly sense the presence of the sled atthe proximate end of the cartridge 34, thus eliminating the need for theknife 32 to fall into the lock-out pocket 2022.

FIGS. 52A and 52B depict a process flow 2200 for operating embodimentsof the surgical instrument 10 configured as an endocutter and having thecapability to record instrument conditions according to variousembodiments. At box 2202, the anvil 24 of the instrument 10 may beclosed. This causes the closure trigger sensor 2002 and or the anvilclosure sensor 2006 to change state. In response, the memory device 2001may record the state of all of the sensors in the system 2000 at box2203. At box 2204, the instrument 10 may be inserted into a patient.When the instrument is inserted, the anvil 24 may be opened and closedat box 2206, for example, to manipulate tissue at the surgical site.Each opening and closing of the anvil 24 causes the closure triggersensor 2002 and/or the anvil closure sensor 2004 to change state. Inresponse, the memory device 2001 records the state of the system 2000 atbox 2205.

At box 2208, tissue is clamped for cutting and stapling. If the anvil 24is not closed at decision block 2210, continued clamping is required. Ifthe anvil 24 is closed, then the sensors 2002, 2004 and/or 2006 maychange state, prompting the memory device 2001 to record the state ofthe system at box 2213. This recording may include a closure pressurereceived from sensor 2006. At box 2212, cutting and stapling may occur.Firing trigger sensor 110 may change state as the firing trigger 20 ispulled toward the pistol grip 26. Also, as the knife 32 moves throughthe staple channel 22, knife position sensor 2008 will change state. Inresponse, the memory device 2001 may record the state of the system 2000at box 2013.

When the cutting and stapling operations are complete, the knife 32 mayreturn to a pre-firing position. Because the cartridge 34 has now beenfired, the knife 32 may fall into lock-out pocket 2022, changing thestate of cartridge condition sensor 2012 and triggering the memorydevice 2001 to record the state of the system 2000 at box 2015. Theanvil 24 may then be opened to clear the tissue. This may cause one ormore of the closure trigger sensor 2002, anvil closure sensor 2004 andanvil closure load sensor 2006 to change state, resulting in arecordation of the state of the system 2000 at box 2017. After thetissue is cleared, the anvil 24 may be again closed at box 2220. Thiscauses another state change for at least sensors 2002 and 2004, which inturn causes the memory device 2001 to record the state of the system atbox 2019. Then the instrument 10 may be removed from the patient at box2222.

If the instrument 10 is to be used again during the same procedure, theanvil may be opened at box 2224, triggering another recordation of thesystem state at box 2223. The spent cartridge 34 may be removed from theend effector 12 at box 2226. This causes cartridge present sensor 2010to change state and cause a recordation of the system state at box 2225.Another cartridge 34 may be inserted at box 2228. This causes a statechange in the cartridge present sensor 2010 and a recordation of thesystem state at box 2227. If the other cartridge 34 is a new cartridge,indicated at decision block 2230, its insertion may also cause a statechange to cartridge condition sensor 2012. In that case, the systemstate may be recorded at box 2231.

FIG. 53 shows an exemplary memory map 2300 from the memory device 2001according to various embodiments. The memory map 2300 includes a seriesof columns 2302, 2304, 2306, 2308, 2310, 2312, 2314, 2316 and rows (notlabeled). Column 2302 shows an event number for each of the rows. Theother columns represent the output of one sensor of the system 2000. Allof the sensor readings recorded at a given time may be recorded in thesame row under the same event number. Hence, each row represents aninstance where one or more of the signals from the sensors of the system2000 are recorded.

Column 2304 lists the closure load recorded at each event. This mayreflect the output of anvil closure load sensor 2006. Column 2306 liststhe firing stroke position. This may be derived from the knife positionsensor 2008. For example, the total travel of the knife 32 may bedivided into partitions. The number listed in column 2306 may representthe partition where the knife 32 is currently present. The firing loadis listed in column 2308. This may be derived from the firing triggersensor 110. The knife position is listed at column 2310. The knifeposition may be derived from the knife position sensor 2008 similar tothe firing stroke. Whether the anvil 24 is open or closed may be listedat column 2312. This value may be derived from the output of the anvilclosure sensor 2004 and/or the anvil closure load sensor 2006. Whetherthe sled 33 is present, or whether the cartridge 34 is spent, may beindicated at column 2314. This value may be derived from the cartridgecondition sensor 2012. Finally, whether the cartridge 34 is present maybe indicated a column 2316. This value may be derived from cartridgepresent sensor 2010. It will be appreciated that various other valuesmay be stored at memory device 2001 including, for example, the end andbeginning of firing strokes, for example, as measured by sensors 130,142.

While the present invention has been illustrated by description ofseveral embodiments and while the illustrative embodiments have beendescribed in considerable detail, it is not the intention of theapplicant to restrict or in any way limit the scope of the appendedclaims to such detail. Additional advantages and modifications mayreadily appear to those skilled in the art.

For example, although the embodiments described above have advantagesfor an endoscopically employed surgical severing and stapling instrument100, a similar embodiments may be used in other clinical procedures. Itis generally accepted that endoscopic procedures are more common thanlaparoscopic procedures. Accordingly, the present invention has beendiscussed in terms of endoscopic procedures and apparatus. However, useherein of terms such as “endoscopic”, should not be construed to limitthe present invention to a surgical instrument for use only inconjunction with an endoscopic tube (i.e., trocar). On the contrary, itis believed that the present invention may find use in any procedurewhere access is limited to a small incision, including but not limitedto laparoscopic procedures, as well as open procedures.

Any patent, publication, or information, in whole or in part, that issaid to be incorporated by reference herein is incorporated herein onlyto the extent that the incorporated material does not conflict withexisting definitions, statements, or other disclosure material set forthin this document. As such the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.

Minimally Invasive Robotic Systems

Over the years a variety of minimally invasive robotic (or“telesurgical”) systems have been developed to increase surgicaldexterity as well as to permit a surgeon to operate on a patient in anintuitive manner. Many of such systems are disclosed in the followingU.S. patents which are each herein incorporated by reference in theirrespective entirety: U.S. Pat. No. 5,792,135, entitled ARTICULATEDSURGICAL INSTRUMENT FOR PERFORMING MINIMALLY INVASIVE SURGERY WITHENHANCED DEXTERITY AND SENSITIVITY, U.S. Pat. No. 6,231,565, entitledROBOTIC ARM DLUS FOR PERFORMING SURGICAL TASKS, U.S. Pat. No. 6,783,524,entitled ROBOTIC SURGICAL TOOL WITH ULTRASOUND CAUTERIZING AND CUTTINGINSTRUMENT, U.S. Pat. No. 6,364,888, entitled ALIGNMENT OF MASTER ANDSLAVE IN A MINIMALLY INVASIVE SURGICAL APPARATUS, U.S. Pat. No.7,524,320, entitled MECHANICAL ACTUATOR INTERFACE SYSTEM FOR ROBOTICSURGICAL TOOLS, U.S. Pat. No. 7,691,098, entitled PLATFORM LINK WRISTMECHANISM, U.S. Pat. No. 7,806,891, entitled REPOSITIONING ANDREORIENTATION OF MASTER/SLAVE RELATIONSHIP IN MINIMALLY INVASIVETELESURGERY, and U.S. Pat. No. 7,824,401, entitled SURGICAL TOOL WITHWRITED MONOPOLAR ELECTROSURGICAL END EFFECTORS. Many of such systems,however, have in the past been unable to generate the magnitude offorces required to effectively cut and fasten tissue.

FIG. 54 depicts one version of a master controller 11001 that may beused in connection with a robotic arm slave cart 11100 of the typedepicted in FIG. 55. Master controller 11001 and robotic arm slave cart11100, as well as their respective components and control systems arecollectively referred to herein as a robotic system 11000. Examples ofsuch systems and devices are disclosed in U.S. Pat. No. 7,524,320 whichhas been herein incorporated by reference. Thus, various details of suchdevices will not be described in detail herein beyond that which may benecessary to understand various embodiments and forms of the presentinvention. As is known, the master controller 11001 generally includesmaster controllers (generally represented as 11003 in FIG. 54) which aregrasped by the surgeon and manipulated in space while the surgeon viewsthe procedure via a stereo display 11002. The master controllers 11001generally comprise manual input devices which preferably move withmultiple degrees of freedom, and which often further have an actuatablehandle for actuating tools (for example, for closing grasping saws,applying an electrical potential to an electrode, or the like).

As can be seen in FIG. 55, in one form, the robotic arm cart 11100 isconfigured to actuate a plurality of surgical tools, generallydesignated as 11200. Various robotic surgery systems and methodsemploying master controller and robotic arm cart arrangements aredisclosed in U.S. Pat. No. 6,132,368, entitled “Multi-ComponentTelepresence System and Method”, the full disclosure of which isincorporated herein by reference. In various forms, the robotic arm cart11100 includes a base 11002 from which, in the illustrated embodiment,three surgical tools 11200 are supported. In various forms, the surgicaltools 11200 are each supported by a series of manually articulatablelinkages, generally referred to as set-up joints 11104, and a roboticmanipulator 11106. These structures are herein illustrated withprotective covers extending over much of the robotic linkage. Theseprotective covers may be optional, and may be limited in size orentirely eliminated in some embodiments to minimize the inertia that isencountered by the servo mechanisms used to manipulate such devices, tolimit the volume of moving components so as to avoid collisions, and tolimit the overall weight of the cart 11100. Cart 11100 will generallyhave dimensions suitable for transporting the cart 11100 betweenoperating rooms. The cart 11100 may be configured to typically fitthrough standard operating room doors and onto standard hospitalelevators. In various forms, the cart 11100 would preferably have aweight and include a wheel (or other transportation) system that allowsthe cart 11100 to be positioned adjacent an operating table by a singleattendant.

Referring now to FIG. 56, in at least one form, robotic manipulators11106 may include a linkage 11108 that constrains movement of thesurgical tool 11200. In various embodiments, linkage 11108 includesrigid links coupled together by rotational joints in a parallelogramarrangement so that the surgical tool 11200 rotates around a point inspace 11110, as more fully described in issued U.S. Pat. No. 5,817,084,the full disclosure of which is herein incorporated by reference. Theparallelogram arrangement constrains rotation to pivoting about an axis11112 a, sometimes called the pitch axis. The links supporting theparallelogram linkage are pivotally mounted to set-up joints 11104 (FIG.55) so that the surgical tool 11200 further rotates about an axis 11112b, sometimes called the yaw axis. The pitch and yaw axes 11112 a, 11112b intersect at the remote center 11114, which is aligned along a shaft11208 of the surgical tool 111200. The surgical tool 11200 may havefurther degrees of driven freedom as supported by manipulator 11106,including sliding motion of the surgical tool 11200 along thelongitudinal tool axis “LT-LT”. As the surgical tool 11200 slides alongthe tool axis LT-LT relative to manipulator 11106 (arrow 11112 c),remote center 11114 remains fixed relative to base 11116 of manipulator11106. Hence, the entire manipulator is generally moved to re-positionremote center 11114. Linkage 11108 of manipulator 11106 is driven by aseries of motors 11120. These motors actively move linkage 11108 inresponse to commands from a processor of a control system. As will bediscussed in further detail below, motors 11120 are also employed tomanipulate the surgical tool 11200.

An alternative set-up joint structure is illustrated in FIG. 57. In thisembodiment, a surgical tool 11200 is supported by an alternativemanipulator structure 11106′ between two tissue manipulation tools.Those of ordinary skill in the art will appreciate that variousembodiments of the present invention may incorporate a wide variety ofalternative robotic structures, including those described in U.S. Pat.No. 5,878,193, entitled AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMALPOSITIONING, the full disclosure of which is incorporated herein byreference. Additionally, while the data communication between a roboticcomponent and the processor of the robotic surgical system is primarilydescribed herein with reference to communication between the surgicaltool 11200 and the master controller 11001, it should be understood thatsimilar communication may take place between circuitry of a manipulator,a set-up joint, an endoscope or other image capture device, or the like,and the processor of the robotic surgical system for componentcompatibility verification, component-type identification, componentcalibration (such as off-set or the like) communication, confirmation ofcoupling of the component to the robotic surgical system, or the like.

Surgical Tools and Interfaces

An exemplary non-limiting surgical tool 11200 that is well-adapted foruse with a robotic system 11000 that has a tool drive assembly 11010(FIG. 59) that is operatively coupled to a master controller 11001 thatis operable by inputs from an operator (i.e., a surgeon) is depicted inFIG. 58. As can be seen in that FIG., the surgical tool 11200 includes asurgical end effector 12012 that comprises an endocutter. In at leastone form, the surgical tool 11200 generally includes an elongated shaftassembly 12008 that has a proximal closure tube 12040 and a distalclosure tube 12042 that are coupled together by an articulation joint12011. The surgical tool 11200 is operably coupled to the manipulator bya tool mounting portion, generally designated as 11300. The surgicaltool 11200 further includes an interface 11230 which mechanically andelectrically couples the tool mounting portion 11300 to the manipulator.One form of interface 11230 is illustrated in FIGS. 59-63. In variousembodiments, the tool mounting portion 11300 includes a tool mountingplate 11302 that operably supports a plurality of (four are shown inFIG. 63) rotatable body portions, driven discs or elements 11304, thateach include a pair of pins 11306 that extend from a surface of thedriven element 11304. One pin 11306 is closer to an axis of rotation ofeach driven elements 11304 than the other pin 11306 on the same drivenelement 11304, which helps to ensure positive angular alignment of thedriven element 11304. Interface 11230 includes an adaptor portion 11240that is configured to mountingly engage the mounting plate 11302 as willbe further discussed below. The adaptor portion 11240 may include anarray of electrical connecting pins 11242 (FIG. 61) which may be coupledto a memory structure by a circuit board within the tool mountingportion 11300. While interface 11230 is described herein with referenceto mechanical, electrical, and magnetic coupling elements, it should beunderstood that a wide variety of telemetry modalities might be used,including infrared, inductive coupling, or the like.

As can be seen in FIGS. 59-62, the adapter portion 11240 generallyincludes a tool side 11244 and a holder side 11246. In various forms, aplurality of rotatable bodies 11250 are mounted to a floating plate11248 which has a limited range of movement relative to the surroundingadaptor structure normal to the major surfaces of the adaptor 11240.Axial movement of the floating plate 11248 helps decouple the rotatablebodies 11250 from the tool mounting portion 11300 when the levers 11303along the sides of the tool mounting portion housing 11301 are actuated(See FIG. 58). Other mechanisms/arrangements may be employed forreleasably coupling the tool mounting portion 11300 to the adaptor11240. In at least one form, rotatable bodies 11250 are resilientlymounted to floating plate 11248 by resilient radial members which extendinto a circumferential indentation about the rotatable bodies 1250. Therotatable bodies 11250 can move axially relative to plate 11248 bydeflection of these resilient structures. When disposed in a first axialposition (toward tool side 11244) the rotatable bodies 11250 are free torotate without angular limitation. However, as the rotatable bodies11250 move axially toward tool side 11244, tabs 11252 (extendingradially from the rotatable bodies 11250) laterally engage detents onthe floating plates so as to limit angular rotation of the rotatablebodies 11250 about their axes. This limited rotation can be used to helpdrivingly engage the rotatable bodies 11250 with drive pins 11272 of acorresponding tool holder portion 11270 of the robotic system 11000, asthe drive pins 11272 will push the rotatable bodies 11250 into thelimited rotation position until the pins 11234 are aligned with (andslide into) openings 11256′. Openings 11256 on the tool side 11244 andopenings 11256′ on the holder side 11246 of rotatable bodies 11250 areconfigured to accurately align the driven elements 11304 (FIG. 63) ofthe tool mounting portion 11300 with the drive elements 11271 of thetool holder 11270. As described above regarding inner and outer pins11306 of driven elements 11304, the openings 11256, 11256′ are atdiffering distances from the axis of rotation on their respectiverotatable bodies 11250 so as to ensure that the alignment is not 180degrees from its intended position. Additionally, each of the openings11256 is slightly radially elongated so as to fittingly receive the pins11306 in the circumferential orientation. This allows the pins 11306 toslide radially within the openings 11256, 11256′ and accommodate someaxial misalignment between the tool 11200 and tool holder 11270, whileminimizing any angular misalignment and backlash between the drive anddriven elements. Openings 11256 on the tool side 11244 are offset byabout 90 degrees from the openings 11256′ (shown in broken lines) on theholder side 11246, as can be seen most clearly in FIG. 62.

Various embodiments may further include an array of electrical connectorpins 11242 located on holder side 11246 of adaptor 11240, and the toolside 11244 of the adaptor 11240 may include slots 11258 (FIG. 62) forreceiving a pin array (not shown) from the tool mounting portion 11300.In addition to transmitting electrical signals between the surgical tool11200 and the tool holder 11270, at least some of these electricalconnections may be coupled to an adaptor memory device 11260 (FIG. 61)by a circuit board of the adaptor 11240.

A detachable latch arrangement 11239 may be employed to releasably affixthe adaptor 11240 to the tool holder 11270. As used herein, the term“tool drive assembly” when used in the context of the robotic system11000, at least encompasses various embodiments of the adapter 11240 andtool holder 11270 and which has been generally designated as 11010 inFIG. 59. For example, as can be seen in FIG. 59, the tool holder 11270may include a first latch pin arrangement 11274 that is sized to bereceived in corresponding clevis slots 11241 provided in the adaptor11240. In addition, the tool holder 11270 may further have second latchpins 11276 that are sized to be retained in corresponding latch devises11243 in the adaptor 11240. See FIG. 61. In at least one form, a latchassembly 11245 is movably supported on the adapter 11240 and is biasablebetween a first latched position wherein the latch pins 11276 areretained within their respective latch clevis 11243 and an unlatchedposition wherein the second latch pins 11276 may be into or removed fromthe latch clevises 11243. A spring or springs (not shown) are employedto bias the latch assembly into the latched position. A lip on the toolside 11244 of adaptor 11240 may slidably receive laterally extendingtabs of tool mounting housing 11301.

Turning next to FIGS. 63-70, in at least one embodiment, the surgicaltool 11200 includes a surgical end effector 12012 that comprises in thisexample, among other things, at least one component 12024 that isselectively movable between first and second positions relative to atleast one other component 12022 in response to various control motionsapplied thereto as will be discussed in further detail below. In variousembodiments, component 12022 comprises an elongated channel 12022configured to operably support a surgical staple cartridge 12034 thereinand component 12024 comprises a pivotally translatable clamping member,such as an anvil 12024. Various embodiments of the surgical end effector12012 are configured to maintain the anvil 12024 and elongated channel12022 at a spacing that assures effective stapling and severing oftissue clamped in the surgical end effector 12012. As can be seen inFIG. 69, the surgical end effector 12012 further includes a cuttinginstrument 12032 and a sled 12033. The cutting instrument 12032 may be,for example, a knife. The surgical staple cartridge 12034 operablyhouses a plurality of surgical staples (not show) therein that aresupported on movable staple drivers (not shown). As the cuttinginstrument 12032 is driven distally through a centrally-disposed slot(not shown) in the surgical staple cartridge 12034, it forces the sled12033 distally as well. As the sled 12033 is driven distally, its“wedge-shaped” configuration contacts the movable staple drivers anddrives them vertically toward the closed anvil 12024. The surgicalstaples are formed as they are driven into the forming surface locatedon the underside of the anvil 12024. The sled 12033 may be part of thesurgical staple cartridge 12034, such that when the cutting instrument12032 is retracted following the cutting operation, the sled 12033 doesnot retract. The anvil 12024 may be pivotably opened and closed at apivot point 12025 located at the proximal end of the elongated channel12022. The anvil 12024 may also include a tab 12027 at its proximal endthat interacts with a component of the mechanical closure system(described further below) to facilitate the opening of the anvil 12024.The elongated channel 12022 and the anvil 12024 may be made of anelectrically conductive material (such as metal) so that they may serveas part of an antenna that communicates with sensor(s) in the endeffector, as described above. The surgical staple cartridge 12034 couldbe made of a nonconductive material (such as plastic) and the sensor maybe connected to or disposed in the surgical staple cartridge 12034, aswas also described above.

As can be seen in FIGS. 63-70, the surgical end effector 12012 isattached to the tool mounting portion 11300 by an elongated shaftassembly 12008 according to various embodiments. As shown in theillustrated embodiment, the shaft assembly 12008 includes anarticulation joint generally indicated as 12011 that enables thesurgical end effector 12012 to be selectively articulated about anarticulation axis AA-AA that is substantially transverse to alongitudinal tool axis LT-LT. See FIG. 64. In other embodiments, thearticulation joint is omitted. In various embodiments, the shaftassembly 12008 may include a closure tube assembly 12009 that comprisesa proximal closure tube 12040 and a distal closure tube 12042 that arepivotably linked by pivot links 12044 and operably supported on a spineassembly generally depicted as 12049. In the illustrated embodiment, thespine assembly 12049 comprises a distal spine portion 12050 that isattached to the elongated channel 12022 and is pivotally coupled to theproximal spine portion 12052. The closure tube assembly 12009 isconfigured to axially slide on the spine assembly 12049 in response toactuation motions applied thereto. The distal closure tube 12042includes an opening 12045 into which the tab 12027 on the anvil 12024 isinserted in order to facilitate opening of the anvil 12024 as the distalclosure tube 12042 is moved axially in the proximal direction “PD”. Theclosure tubes 12040, 12042 may be made of electrically conductivematerial (such as metal) so that they may serve as part of the antenna,as described above. Components of the main drive shaft assembly (e.g.,the drive shafts 12048, 12050) may be made of a nonconductive material(such as plastic).

In use, it may be desirable to rotate the surgical end effector 12012about the longitudinal tool axis LT-LT. In at least one embodiment, thetool mounting portion 11300 includes a rotational transmission assembly12069 that is configured to receive a corresponding rotary output motionfrom the tool drive assembly 11010 of the robotic system 11000 andconvert that rotary output motion to a rotary control motion forrotating the elongated shaft assembly 12008 (and surgical end effector12012) about the longitudinal tool axis LT-LT. In various embodiments,for example, the proximal end 12060 of the proximal closure tube 12040is rotatably supported on the tool mounting plate 11302 of the toolmounting portion 11300 by a forward support cradle 11309 and a closuresled 12100 that is also movably supported on the tool mounting plate11302. In at least one form, the rotational transmission assembly 12069includes a tube gear segment 12062 that is formed on (or attached to)the proximal end 12060 of the proximal closure tube 12040 for operableengagement by a rotational gear assembly 12070 that is operablysupported on the tool mounting plate 11302. As can be seen in FIG. 66,the rotational gear assembly 12070, in at least one embodiment,comprises a rotation drive gear 12072 that is coupled to a correspondingfirst one of the driven discs or elements 11304 on the adapter side11307 of the tool mounting plate 11302 when the tool mounting portion11300 is coupled to the tool drive assembly 11010. See FIG. 63. Therotational gear assembly 12070 further comprises a rotary driven gear12074 that is rotatably supported on the tool mounting plate 11302 inmeshing engagement with the tube gear segment 12062 and the rotationdrive gear 12072. Application of a first rotary output motion from thetool drive assembly 11010 of the robotic system 11000 to thecorresponding driven element 11304 will thereby cause rotation of therotation drive gear 12072. Rotation of the rotation drive gear 12072ultimately results in the rotation of the elongated shaft assembly 12008(and the surgical end effector 12012) about the longitudinal tool axisLT-LT (represented by arrow “R” in FIG. 66). It will be appreciated thatthe application of a rotary output motion from the tool drive assembly11010 in one direction will result in the rotation of the elongatedshaft assembly 12008 and surgical end effector 12012 about thelongitudinal tool axis LT-LT in a first direction and an application ofthe rotary output motion in an opposite direction will result in therotation of the elongated shaft assembly 12008 and surgical end effector12012 in a second direction that is opposite to the first direction.

In at least one embodiment, the closure of the anvil 12024 relative tothe staple cartridge 12034 is accomplished by axially moving the closuretube assembly 12009 in the distal direction “DD” on the spine assembly12049. As indicated above, in various embodiments, the proximal end12060 of the proximal closure tube 12040 is supported by the closuresled 12100 which comprises a portion of a closure transmission,generally depicted as 12099. In at least one form, the closure sled12100 is configured to support the closure tube 12009 on the toolmounting plate 11320 such that the proximal closure tube 12040 canrotate relative to the closure sled 12100, yet travel axially with theclosure sled 12100. In particular, as can be seen in FIG. 71, theclosure sled 12100 has an upstanding tab 12101 that extends into aradial groove 12063 in the proximal end portion of the proximal closuretube 12040. In addition, as can be seen in FIGS. 68 and 71, the closuresled 12100 has a tab portion 12102 that extends through a slot 11305 inthe tool mounting plate 11302. The tab portion 12102 is configured toretain the closure sled 12100 in sliding engagement with the toolmounting plate 11302. In various embodiments, the closure sled 12100 hasan upstanding portion 12104 that has a closure rack gear 12106 formedthereon. The closure rack gear 12106 is configured for drivingengagement with a closure gear assembly 12110. See FIG. 68.

In various forms, the closure gear assembly 12110 includes a closurespur gear 12112 that is coupled to a corresponding second one of thedriven discs or elements 11304 on the adapter side 11307 of the toolmounting plate 11302. See FIG. 63. Thus, application of a second rotaryoutput motion from the tool drive assembly 11010 of the robotic system11000 to the corresponding second driven element 11304 will causerotation of the closure spur gear 12112 when the tool mounting portion11300 is coupled to the tool drive assembly 11010. The closure gearassembly 12110 further includes a closure reduction gear set 12114 thatis supported in meshing engagement with the closure spur gear 12112. Ascan be seen in FIGS. 67 and 68, the closure reduction gear set 12114includes a driven gear 12116 that is rotatably supported in meshingengagement with the closure spur gear 12112. The closure reduction gearset 12114 further includes a first closure drive gear 12118 that is inmeshing engagement with a second closure drive gear 12120 that isrotatably supported on the tool mounting plate 11302 in meshingengagement with the closure rack gear 12106. Thus, application of asecond rotary output motion from the tool drive assembly 11010 of therobotic system 11000 to the corresponding second driven element 11304will cause rotation of the closure spur gear 12112 and the closuretransmission 12110 and ultimately drive the closure sled 12100 andclosure tube assembly 12009 axially. The axial direction in which theclosure tube assembly 12009 moves ultimately depends upon the directionin which the second driven element 11304 is rotated. For example, inresponse to one rotary output motion received from the tool driveassembly 11010 of the robotic system 11000, the closure sled 12100 willbe driven in the distal direction “DD” and ultimately drive the closuretube assembly 11009 in the distal direction. As the distal closure tube12042 is driven distally, the end of the closure tube segment 12042 willengage a portion of the anvil 12024 and cause the anvil 12024 to pivotto a closed position. Upon application of an “opening” output motionfrom the tool drive assembly 11010 of the robotic system 11000, theclosure sled 12100 and shaft assembly 12008 will be driven in theproximal direction “PD”. As the distal closure tube 12042 is driven inthe proximal direction, the opening 12045 therein interacts with the tab12027 on the anvil 12024 to facilitate the opening thereof. In variousembodiments, a spring (not shown) may be employed to bias the anvil tothe open position when the distal closure tube 12042 has been moved toits starting position. In various embodiments, the various gears of theclosure gear assembly 12110 are sized to generate the necessary closureforces needed to satisfactorily close the anvil 12024 onto the tissue tobe cut and stapled by the surgical end effector 12012. For example, thegears of the closure transmission 12110 may be sized to generateapproximately 70-120 pounds.

In various embodiments, the cutting instrument 12032 is driven throughthe surgical end effector 12012 by a knife bar 12200. See FIGS. 69 and71. In at least one form, the knife bar 12200 may be fabricated from,for example, stainless steel or other similar material and has asubstantially rectangular cross-sectional shape. Such knife barconfiguration is sufficiently rigid to push the cutting instrument 12032through tissue clamped in the surgical end effector 12012, while stillbeing flexible enough to enable the surgical end effector 12012 toarticulate relative to the proximal closure tube 12040 and the proximalspine portion 12052 about the articulation axis AA-AA as will bediscussed in further detail below. As can be seen in FIGS. 72 and 73,the proximal spine portion 12052 has a rectangular-shaped passage 12054extending therethrough to provide support to the knife bar 12200 as itis axially pushed therethrough. The proximal spine portion 12052 has aproximal end 12056 that is rotatably mounted to a spine mounting bracket12057 attached to the tool mounting plate 11032. See FIG. 71. Sucharrangement permits the proximal spine portion 12052 to rotate, but notmove axially, within the proximal closure tube 12040.

As shown in FIG. 69, the distal end 12202 of the knife bar 12200 isattached to the cutting instrument 12032. The proximal end 12204 of theknife bar 12200 is rotatably affixed to a knife rack gear 12206 suchthat the knife bar 12200 is free to rotate relative to the knife rackgear 12206. See FIG. 71. As can be seen in FIGS. 65-70, the knife rackgear 12206 is slidably supported within a rack housing 12210 that isattached to the tool mounting plate 11302 such that the knife rack gear12206 is retained in meshing engagement with a knife gear assembly12220. More specifically and with reference to FIG. 68, in at least oneembodiment, the knife gear assembly 12220 includes a knife spur gear12222 that is coupled to a corresponding third one of the driven discsor elements 11304 on the adapter side 11307 of the tool mounting plate11302. See FIG. 63. Thus, application of another rotary output motionfrom the robotic system 11000 through the tool drive assembly 11010 tothe corresponding third driven element 11304 will cause rotation of theknife spur gear 12222. The knife gear assembly 12220 further includes aknife gear reduction set 12224 that includes a first knife driven gear12226 and a second knife drive gear 12228. The knife gear reduction set12224 is rotatably mounted to the tool mounting plate 11302 such thatthe first knife driven gear 12226 is in meshing engagement with theknife spur gear 12222. Likewise, the second knife drive gear 12228 is inmeshing engagement with a third knife drive gear 12230 that is rotatablysupported on the tool mounting plate 11302 in meshing engagement withthe knife rack gear 12206. In various embodiments, the gears of theknife gear assembly 12220 are sized to generate the forces needed todrive the cutting element 12032 through the tissue clamped in thesurgical end effector 12012 and actuate the staples therein. Forexample, the gears of the knife drive assembly 12230 may be sized togenerate approximately 40 to 100 pounds. It will be appreciated that theapplication of a rotary output motion from the tool drive assembly 11010in one direction will result in the axial movement of the cuttinginstrument 12032 in a distal direction and application of the rotaryoutput motion in an opposite direction will result in the axial travelof the cutting instrument 12032 in a proximal direction.

In various embodiments, the surgical tool 11200 employs an articulationsystem 12007 that includes an articulation joint 12011 that enables thesurgical end effector 12012 to be articulated about an articulation axisAA-AA that is substantially transverse to the longitudinal tool axisLT-LT. In at least one embodiment, the surgical tool 11200 includesfirst and second articulation bars 12250 a, 12250 b that are slidablysupported within corresponding passages 12053 provided through theproximal spine portion 12052. See FIGS. 71 and 73. In at least one form,the first and second articulation bars 12250 a, 12250 b are actuated byan articulation transmission generally designated as 12249 that isoperably supported on the tool mounting plate 11032. Each of thearticulation bars 12250 a, 12250 b has a proximal end 12252 that has aguide rod protruding therefrom which extend laterally through acorresponding slot in the proximal end portion of the proximal spineportion 12052 and into a corresponding arcuate slot in an articulationnut 12260 which comprises a portion of the articulation transmission.FIG. 72 illustrates articulation bar 12250 a. It will be understood thatarticulation bar 12250 b is similarly constructed. As can be seen inFIG. 72, for example, the articulation bar 12250 a has a guide rod 12254which extends laterally through a corresponding slot 12058 in theproximal end portion 12056 of the distal spine portion 12050 and into acorresponding arcuate slot 12262 in the articulation nut 12260. Inaddition, the articulation bar 12250 a has a distal end 12251 a that ispivotally coupled to the distal spine portion 12050 by, for example, apin 12253 a and articulation bar 12250 b has a distal end 12251 b thatis pivotally coupled to the distal spine portion 12050 by, for example,a pin 12253 b. In particular, the articulation bar 12250 a is laterallyoffset in a first lateral direction from the longitudinal tool axisLT-LT and the articulation bar 12250 b is laterally offset in a secondlateral direction from the longitudinal tool axis LT-LT. Thus, axialmovement of the articulation bars 12250 a and 12250 b in opposingdirections will result in the articulation of the distal spine portion12050 as well as the surgical end effector 12012 attached thereto aboutthe articulation axis AA-AA as will be discussed in further detailbelow.

Articulation of the surgical end effector 12012 is controlled byrotating the articulation nut 12260 about the longitudinal tool axisLT-LT. The articulation nut 12260 is rotatably journaled on the proximalend portion 12056 of the distal spine portion 12050 and is rotatablydriven thereon by an articulation gear assembly 12270. More specificallyand with reference to FIG. 66, in at least one embodiment, thearticulation gear assembly 12270 includes an articulation spur gear12272 that is coupled to a corresponding fourth one of the driven discsor elements 11304 on the adapter side 11307 of the tool mounting plate11302. See FIG. 63. Thus, application of another rotary input motionfrom the robotic system 11000 through the tool drive assembly 11010 tothe corresponding fourth driven element 11304 will cause rotation of thearticulation spur gear 12272 when the interface 11230 is coupled to thetool holder 11270. An articulation drive gear 12274 is rotatablysupported on the tool mounting plate 11302 in meshing engagement withthe articulation spur gear 12272 and a gear portion 12264 of thearticulation nut 12260 as shown. As can be seen in FIGS. 71 and 72, thearticulation nut 12260 has a shoulder 12266 formed thereon that definesan annular groove 12267 for receiving retaining posts 12268 therein.Retaining posts 12268 are attached to the tool mounting plate 11302 andserve to prevent the articulation nut 12260 from moving axially on theproximal spine portion 12052 while maintaining the ability to be rotatedrelative thereto. Thus, rotation of the articulation nut 12260 in afirst direction, will result in the axial movement of the articulationbar 12250 a in a distal direction “DD” and the axial movement of thearticulation bar 12250 b in a proximal direction “PD” because of theinteraction of the guide rods 12254 with the spiral slots 12262 in thearticulation gear 12260. Similarly, rotation of the articulation nut12260 in a second direction that is opposite to the first direction willresult in the axial movement of the articulation bar 12250 a in theproximal direction “PD” as well as cause articulation bar 2250 b toaxially move in the distal direction “DD”. Thus, the surgical endeffector 12012 may be selectively articulated about articulation axis“AA-AA” in a first direction “FD” by simultaneously moving thearticulation bar 12250 a in the distal direction “DD” and thearticulation bar 12250 b in the proximal direction “PD”. Likewise, thesurgical end effector 12012 may be selectively articulated about thearticulation axis “AA-AA” in a second direction “SD” by simultaneouslymoving the articulation bar 12250 a in the proximal direction “PD” andthe articulation bar 12250 b in the distal direction “DD.” See FIG. 64.

The tool embodiment described above employs an interface arrangementthat is particularly well-suited for mounting the roboticallycontrollable medical tool onto at least one form of robotic armarrangement that generates at least four different rotary controlmotions. Those of ordinary skill in the art will appreciate that suchrotary output motions may be selectively controlled through theprogrammable control systems employed by the robotic system/controller.For example, the tool arrangement described above may be well-suited foruse with those robotic systems manufactured by Intuitive Surgical, Inc.of Sunnyvale, Calif., U.S.A., many of which may be described in detailin various patents incorporated herein by reference. The unique andnovel aspects of various embodiments of the present invention serve toutilize the rotary output motions supplied by the robotic system togenerate specific control motions having sufficient magnitudes thatenable end effectors to cut and staple tissue. Thus, the uniquearrangements and principles of various embodiments of the presentinvention may enable a variety of different forms of the tool systemsdisclosed and claimed herein to be effectively employed in connectionwith other types and forms of robotic systems that supply programmedrotary or other output motions. In addition, as will become furtherapparent as the present Detailed Description proceeds, various endeffector embodiments of the present invention that require other formsof actuation motions may also be effectively actuated utilizing one ormore of the control motions generated by the robotic system.

FIGS. 75-79 illustrate yet another surgical tool 12300 that may beeffectively employed in connection with the robotic system 11000 thathas a tool drive assembly that is operably coupled to a controller ofthe robotic system that is operable by inputs from an operator and whichis configured to provide at least one rotary output motion to at leastone rotatable body portion supported on the tool drive assembly. Invarious forms, the surgical tool 12300 includes a surgical end effector12312 that includes an elongated channel 12322 and a pivotallytranslatable clamping member, such as an anvil 12324, which aremaintained at a spacing that assures effective stapling and severing oftissue clamped in the surgical end effector 12312. As shown in theillustrated embodiment, the surgical end effector 12312 may include, inaddition to the previously-mentioned elongated channel 12322 and anvil12324, a cutting instrument 12332 that has a sled portion 12333 formedthereon, a surgical staple cartridge 12334 that is seated in theelongated channel 12322, and a rotary end effector drive shaft 12336that has a helical screw thread formed thereon. The cutting instrument12332 may be, for example, a knife. As will be discussed in furtherdetail below, rotation of the end effector drive shaft 12336 will causethe cutting instrument 12332 and sled portion 12333 to axially travelthrough the surgical staple cartridge 2334 to move between a startingposition and an ending position. The direction of axial travel of thecutting instrument 12332 depends upon the direction in which the endeffector drive shaft 12336 is rotated. The anvil 12324 may be pivotablyopened and closed at a pivot point 12325 connected to the proximate endof the elongated channel 12322. The anvil 12324 may also include a tab12327 at its proximate end that operably interfaces with a component ofthe mechanical closure system (described further below) to open andclose the anvil 12324. When the end effector drive shaft 12336 isrotated, the cutting instrument 12332 and sled 12333 will travellongitudinally through the surgical staple cartridge 12334 from thestarting position to the ending position, thereby cutting tissue clampedwithin the surgical end effector 12312. The movement of the sled 12333through the surgical staple cartridge 12334 causes the staples thereinto be driven through the severed tissue and against the closed anvil12324, which turns the staples to fasten the severed tissue. In oneform, the elongated channel 12322 and the anvil 12324 may be made of anelectrically conductive material (such as metal) so that they may serveas part of the antenna that communicates with sensor(s) in the endeffector, as described above. The surgical staple cartridge 12334 couldbe made of a nonconductive material (such as plastic) and the sensor maybe connected to or disposed in the surgical staple cartridge 12334, asdescribed above.

It should be noted that although the embodiments of the surgical tool12300 described herein employ a surgical end effector 12312 that staplesthe severed tissue, in other embodiments different techniques forfastening or sealing the severed tissue may be used. For example, endeffectors that use RF energy or adhesives to fasten the severed tissuemay also be used. U.S. Pat. No. 5,709,680, entitled ELECTROSURGICALHEMOSTATIC DEVICE to Yates et al., and U.S. Pat. No. 5,688,270, entitledELECTROSURGICAL HEMOSTATIC DEVICE WITH RECESSED AND/OR OFFSET ELECTRODESto Yates et al., which are incorporated herein by reference, disclosescutting instruments that use RF energy to fasten the severed tissue.U.S. patent application Ser. No. 11/267,811 to Morgan et al. now U.S.Pat. No. 7,673,783, and U.S. patent application Ser. No. 11/267,383 toShelton et al., now U.S. Pat. No. 7,607,557, which are also incorporatedherein by reference, disclose cutting instruments that use adhesives tofasten the severed tissue. Accordingly, although the description hereinrefers to cutting/stapling operations and the like, it should berecognized that this is an exemplary embodiment and is not meant to belimiting. Other tissue-fastening techniques may also be used.

In the illustrated embodiment, the surgical end effector 12312 iscoupled to an elongated shaft assembly 12308 that is coupled to a toolmounting portion 12460 and defines a longitudinal tool axis LT-LT. Inthis embodiment, the elongated shaft assembly 12308 does not include anarticulation joint. Those of ordinary skill in the art will understandthat other embodiments may have an articulation joint therein. In atleast one embodiment, the elongated shaft assembly 12308 comprises ahollow outer tube 12340 that is rotatably supported on a tool mountingplate 12462 of a tool mounting portion 12460 as will be discussed infurther detail below. In various embodiments, the elongated shaftassembly 12308 further includes a distal spine shaft 12350. Distal spineshaft 12350 has a distal end portion 12354 that is coupled to, orotherwise integrally formed with, a distal stationary base portion 12360that is non-movably coupled to the channel 12322. See FIGS. 76-78.

As shown in FIG. 76, the distal spine shaft 12350 has a proximal endportion 12351 that is slidably received within a slot 12355 in aproximal spine shaft 12353 that is non-movably supported within thehollow outer tube 12340 by at least one support collar 12357. As can befurther seen in FIGS. 76 and 77, the surgical tool 12300 includes aclosure tube 12370 that is constrained to only move axially relative tothe distal stationary base portion 12360. The closure tube 12370 has aproximal end 12372 that has an internal thread 12374 formed therein thatis in threaded engagement with a transmission arrangement, generallydepicted as 12375 that is operably supported on the tool mounting plate12462. In various forms, the transmission arrangement 12375 includes arotary drive shaft assembly, generally designated as 12381. Whenrotated, the rotary drive shaft assembly 12381 will cause the closuretube 12370 to move axially as will be describe in further detail below.In at least one form, the rotary drive shaft assembly 12381 includes aclosure drive nut 12382 of a closure clutch assembly generallydesignated as 12380. More specifically, the closure drive nut 12382 hasa proximal end portion 12384 that is rotatably supported relative to theouter tube 12340 and is in threaded engagement with the closure tube12370. For assembly purposes, the proximal end portion 12384 may bethreadably attached to a retention ring 12386. Retention ring 12386, incooperation with an end 12387 of the closure drive nut 12382, defines anannular slot 12388 into which a shoulder 12392 of a locking collar 12390extends. The locking collar 12390 is non-movably attached (e.g., welded,glued, etc.) to the end of the outer tube 12340. Such arrangement servesto affix the closure drive nut 12382 to the outer tube 12340 whileenabling the closure drive nut 12382 to rotate relative to the outertube 12340. The closure drive nut 12382 further has a distal end 12383that has a threaded portion 12385 that threadably engages the internalthread 12374 of the closure tube 12370. Thus, rotation of the closuredrive nut 12382 will cause the closure tube 12370 to move axially asrepresented by arrow “D” in FIG. 77.

Closure of the anvil 12324 and actuation of the cutting instrument 12332are accomplished by control motions that are transmitted by a hollowdrive sleeve 12400. As can be seen in FIGS. 76 and 77, the hollow drivesleeve 12400 is rotatably and slidably received on the distal spineshaft 12350. The drive sleeve 12400 has a proximal end portion 12401that is rotatably mounted to the proximal spine shaft 12353 thatprotrudes from the tool mounting portion 12460 such that the drivesleeve 12400 may rotate relative thereto. See FIG. 76. As can also beseen in FIGS. 76-78, the drive sleeve 12400 is rotated about thelongitudinal tool axis “LT-LT” by a drive shaft 12440. The drive shaft12440 has a drive gear 12444 that is attached to its distal end 12442and is in meshing engagement with a driven gear 12450 that is attachedto the drive sleeve 12400.

The drive sleeve 12400 further has a distal end portion 12402 that iscoupled to a closure clutch 12410 portion of the closure clutch assembly12380 that has a proximal face 12412 and a distal face 12414. Theproximal face 12412 has a series of proximal teeth 12416 formed thereonthat are adapted for selective engagement with corresponding proximalteeth cavities 12418 formed in the proximal end portion 12384 of theclosure drive nut 12382. Thus, when the proximal teeth 12416 are inmeshing engagement with the proximal teeth cavities 12418 in the closuredrive nut 12382, rotation of the drive sleeve 12400 will result inrotation of the closure drive nut 12382 and ultimately cause the closuretube 12370 to move axially as will be discussed in further detail below.

As can be most particularly seen in FIGS. 76 and 77, the distal face12414 of the drive clutch portion 12410 has a series of distal teeth12415 formed thereon that are adapted for selective engagement withcorresponding distal teeth cavities 12426 formed in a face plate portion12424 of a knife drive shaft assembly 12420. In various embodiments, theknife drive shaft assembly 12420 comprises a hollow knife shaft segment12430 that is rotatably received on a corresponding portion of thedistal spine shaft 12350 that is attached to or protrudes from thestationary base 12360. When the distal teeth 12415 of the closure clutchportion 12410 are in meshing engagement with the distal teeth cavities12426 in the face plate portion 12424, rotation of the drive sleeve12400 will result in rotation of the drive shaft segment 12430 about thestationary shaft 12350. As can be seen in FIGS. 76-77, a knife drivegear 12432 is attached to the drive shaft segment 12430 and is meshingengagement with a drive knife gear 12434 that is attached to the endeffector drive shaft 12336. Thus, rotation of the drive shaft segment12430 will result in the rotation of the end effector drive shaft 12336to drive the cutting instrument 12332 and sled 12333 distally throughthe surgical staple cartridge 12334 to cut and staple tissue clampedwithin the surgical end effector 12312. The sled 12333 may be made of,for example, plastic, and may have a sloped distal surface. As the sled12333 traverses the elongated channel 12322, the sloped forward surfaceof the sled 12333 pushes up or “drive” the staples in the surgicalstaple cartridge 12334 through the clamped tissue and against the anvil12324. The anvil 12324 turns or “forms” the staples, thereby staplingthe severed tissue. As used herein, the term “fire” refers to theinitiation of actions required to drive the cutting instrument and sledportion in a distal direction through the surgical staple cartridge tocut the tissue clamped in the surgical end effector and drive thestaples through the severed tissue.

In use, it may be desirable to rotate the surgical end effector 12312about the longitudinal tool axis LT-LT. In at least one embodiment, thetransmission arrangement 12375 includes a rotational transmissionassembly 12465 that is configured to receive a corresponding rotaryoutput motion from the tool drive assembly 11010 of the robotic system11000 and convert that rotary output motion to a rotary control motionfor rotating the elongated shaft assembly 12308 (and surgical endeffector 12312) about the longitudinal tool axis LT-LT. As can be seenin FIG. 79, a proximal end 12341 of the outer tube 12340 is rotatablysupported within a cradle arrangement 12343 attached to the toolmounting plate 12462 of the tool mounting portion 12460. A rotation gear12345 is formed on or attached to the proximal end 12341 of the outertube 12340 of the elongated shaft assembly 12308 for meshing engagementwith a rotation gear assembly 12470 operably supported on the toolmounting plate 12462. In at least one embodiment, a rotation drive gear12472 is coupled to a corresponding first one of the driven discs orelements 11304 on the adapter side of the tool mounting plate 12462 whenthe tool mounting portion 12460 is coupled to the tool drive assembly11010. See FIGS. 63 and 79. The rotation drive assembly 12470 furthercomprises a rotary driven gear 12474 that is rotatably supported on thetool mounting plate 12462 in meshing engagement with the rotation gear12345 and the rotation drive gear 12472. Application of a first rotaryoutput motion from the robotic system 11000 through the tool driveassembly 11010 to the corresponding driven element 11304 will therebycause rotation of the rotation drive gear 12472 by virtue of beingoperably coupled thereto. Rotation of the rotation drive gear 12472ultimately results in the rotation of the elongated shaft assembly 12308(and the end effector 12312) about the longitudinal tool axis LT-LT(primary rotary motion).

Closure of the anvil 12324 relative to the staple cartridge 12034 isaccomplished by axially moving the closure tube 12370 in the distaldirection “DD”. Axial movement of the closure tube 12370 in the distaldirection “DD” is accomplished by applying a rotary control motion tothe closure drive nut 12382. To apply the rotary control motion to theclosure drive nut 12382, the closure clutch 12410 must first be broughtinto meshing engagement with the proximal end portion 12384 of theclosure drive nut 12382. In various embodiments, the transmissionarrangement 12375 further includes a shifter drive assembly 12480 thatis operably supported on the tool mounting plate 12462. Morespecifically and with reference to FIG. 79, it can be seen that aproximal end portion 12359 of the proximal spine portion 12353 extendsthrough the rotation gear 12345 and is rotatably coupled to a shiftergear rack 12481 that is slidably affixed to the tool mounting plate12462 through slots 12482. The shifter drive assembly 12480 furthercomprises a shifter drive gear 12483 that is coupled to a correspondingsecond one of the driven discs or elements 11304 on the adapter side ofthe tool mounting plate 12462 when the tool mounting portion 12460 iscoupled to the tool holder 11270. See FIGS. 63 and 79. The shifter driveassembly 12480 further comprises a shifter driven gear 12478 that isrotatably supported on the tool mounting plate 12462 in meshingengagement with the shifter drive gear 12483 and the shifter rack gear12482. Application of a second rotary output motion from the roboticsystem 11000 through the tool drive assembly 11010 to the correspondingdriven element 11304 will thereby cause rotation of the shifter drivegear 12483 by virtue of being operably coupled thereto. Rotation of theshifter drive gear 12483 ultimately results in the axial movement of theshifter gear rack 12482 and the proximal spine portion 12353 as well asthe drive sleeve 12400 and the closure clutch 12410 attached thereto.The direction of axial travel of the closure clutch 12410 depends uponthe direction in which the shifter drive gear 12483 is rotated by therobotic system 11000. Thus, rotation of the shifter drive gear 12483 ina first rotary direction will result in the axial movement of theclosure clutch 12410 in the proximal direction “PD” to bring theproximal teeth 12416 into meshing engagement with the proximal teethcavities 12418 in the closure drive nut 12382. Conversely, rotation ofthe shifter drive gear 12483 in a second rotary direction (opposite tothe first rotary direction) will result in the axial movement of theclosure clutch 12410 in the distal direction “DD” to bring the distalteeth 12415 into meshing engagement with corresponding distal teethcavities 12426 formed in the face plate portion 12424 of the knife driveshaft assembly 12420.

Once the closure clutch 12410 has been brought into meshing engagementwith the closure drive nut 12382, the closure drive nut 12382 is rotatedby rotating the closure clutch 12410. Rotation of the closure clutch12410 is controlled by applying rotary output motions to a rotary drivetransmission portion 12490 of transmission arrangement 12375 that isoperably supported on the tool mounting plate 12462 as shown in FIG. 79.In at least one embodiment, the rotary drive transmission 12490 includesa rotary drive assembly 12490′ that includes a gear 12491 that iscoupled to a corresponding third one of the driven discs or elements11304 on the adapter side of the tool mounting plate 12462 when the toolmounting portion 12460 is coupled to the tool holder 11270. See FIGS. 63and 79. The rotary drive transmission 12490 further comprises a firstrotary driven gear 12492 that is rotatably supported on the toolmounting plate 12462 in meshing engagement with a second rotary drivengear 12493 and the rotary drive gear 12491. The second rotary drivengear 12493 is coupled to a proximal end portion 12443 of the drive shaft12440.

Rotation of the rotary drive gear 12491 in a first rotary direction willresult in the rotation of the drive shaft 12440 in a first direction.Conversely, rotation of the rotary drive gear 12491 in a second rotarydirection (opposite to the first rotary direction) will cause the driveshaft 12440 to rotate in a second direction. As indicated above, thedrive shaft 12440 has a drive gear 12444 that is attached to its distalend 12442 and is in meshing engagement with a driven gear 12450 that isattached to the drive sleeve 12400. Thus, rotation of the drive shaft12440 results in rotation of the drive sleeve 12400.

A method of operating the surgical tool 12300 will now be described.Once the tool mounting portion 12462 has been operably coupled to thetool holder 11270 of the robotic system 11000 and oriented into positionadjacent the target tissue to be cut and stapled, if the anvil 12334 isnot already in the open position (FIG. 76), the robotic system 11000 mayapply the first rotary output motion to the shifter drive gear 12483which results in the axial movement of the closure clutch 12410 intomeshing engagement with the closure drive nut 12382 (if it is notalready in meshing engagement therewith). See FIG. 77. Once thecontroller 11001 of the robotic system 11000 has confirmed that theclosure clutch 12410 is meshing engagement with the closure drive nut12382 (e.g., by means of sensor(s)) in the surgical end effector 12312that are in communication with the robotic control system), the roboticcontroller 11001 may then apply a second rotary output motion to therotary drive gear 12492 which, as was described above, ultimatelyresults in the rotation of the rotary drive nut 12382 in the firstdirection which results in the axial travel of the closure tube 12370 inthe distal direction “DD”. As the closure tube 12370 moved in the distaldirection, it contacts a portion of the anvil 12323 and causes the anvil12324 to pivot to the closed position to clamp the target tissue betweenthe anvil 12324 and the surgical staple cartridge 12334. Once therobotic controller 11001 determines that the anvil 12334 has beenpivoted to the closed position by corresponding sensor(s) in thesurgical end effector 12312 in communication therewith, the roboticsystem 11000 discontinues the application of the second rotary outputmotion to the rotary drive gear 12491. The robotic controller 11001 mayalso provide the surgeon with an indication that the anvil 12334 hasbeen fully closed. The surgeon may then initiate the firing procedure.In alternative embodiments, the firing procedure may be automaticallyinitiated by the robotic controller 11001. The robotic controller 11001then applies the primary rotary control motion 12483 to the shifterdrive gear 12483 which results in the axial movement of the closureclutch 12410 into meshing engagement with the face plate portion 12424of the knife drive shaft assembly 12420. See FIG. 78. Once thecontroller 11001 of the robotic system 11000 has confirmed that theclosure clutch 12410 is meshing engagement with the face plate portion12424 (by means of sensor(s)) in the end effector 12312 that are incommunication with the robotic controller 11001), the robotic controller11001 may then apply the second rotary output motion to the rotary drivegear 12492 which, as was described above, ultimately results in theaxial movement of the cutting instrument 12332 and sled portion 12333 inthe distal direction “DD” through the surgical staple cartridge 12334.As the cutting instrument 12332 moves distally through the surgicalstaple cartridge 12334, the tissue clamped therein is severed. As thesled portion 12333 is driven distally, it causes the staples within thesurgical staple cartridge to be driven through the severed tissue intoforming contact with the anvil 12324. Once the robotic controller 11001has determined that the cutting instrument 12324 has reached the endposition within the surgical staple cartridge 12334 (by means ofsensor(s)) in the end effector 12312 that are in communication with therobotic controller 11001), the robotic controller 11001 discontinues theapplication of the second rotary output motion to the rotary drive gear12491. Thereafter, the robotic controller 11001 applies the secondaryrotary output motion to the rotary drive gear 12491 which ultimatelyresults in the axial travel of the cutting instrument 12332 and sledportion 12333 in the proximal direction “PD” to the starting position.Once the robotic controller 11001 has determined that the cuttinginstrument 12324 has reached the starting position by means of sensor(s)in the surgical end effector 12312 that are in communication with therobotic controller 11001, the robotic controller 11001 discontinues theapplication of the secondary rotary output motion to the rotary drivegear 12491. Thereafter, the robotic controller 11001 applies the primaryrotary output motion to the shifter drive gear 12483 to cause theclosure clutch 12410 to move into engagement with the rotary drive nut12382. Once the closure clutch 12410 has been moved into meshingengagement with the rotary drive nut 12382, the robotic controller 11001then applies the secondary output motion to the rotary drive gear 12491which ultimately results in the rotation of the rotary drive nut 12382in the second direction to cause the closure tube 12370 to move in theproximal direction “PD”. As can be seen in FIGS. 76-78, the closure tube12370 has an opening 12344 therein that engages the tab 12327 on theanvil 12324 to cause the anvil 12324 to pivot to the open position. Inalternative embodiments, a spring may also be employed to pivot theanvil 12324 to the open position when the closure tube 12370 has beenreturned to the starting position (FIG. 76).

FIGS. 80-84 illustrate yet another surgical tool 12500 that may beeffectively employed in connection with the robotic system 11000. Invarious forms, the surgical tool 12500 includes a surgical end effector12512 that includes a “first portion” in the form of an elongatedchannel 12522 and a “second movable portion” in the form of a pivotallytranslatable clamping member, such as an anvil 12524, which aremaintained at a spacing that assures effective stapling and severing oftissue clamped in the surgical end effector 12512. As shown in theillustrated embodiment, the surgical end effector 12512 may include, inaddition to the previously-mentioned elongated channel 12522 and anvil12524, a “third movable portion” in the form of a cutting instrument12532, a sled (not shown), and a surgical staple cartridge 12534 that isremovably seated in the elongated channel 12522. The cutting instrument12532 may be, for example, a knife. The anvil 12524 may be pivotablyopened and closed at a pivot point 12525 connected to the proximate endof the elongated channel 12522. The anvil 12524 may also include a tab12527 at its proximate end that is configured to operably interface witha component of the mechanical closure system (described further below)to open and close the anvil 12524. When actuated, the knife 12532 andsled travel longitudinally along the elongated channel 12522, therebycutting tissue clamped within the surgical end effector 12512. Themovement of the sled along the elongated channel 12522 causes thestaples of the surgical staple cartridge 12534 to be driven through thesevered tissue and against the closed anvil 12524, which turns thestaples to fasten the severed tissue. In one form, the elongated channel12522 and the anvil 12524 may be made of an electrically conductivematerial (such as metal) so that they may serve as part of the antennathat communicates with sensor(s) in the surgical end effector, asdescribed above. The surgical staple cartridge 12534 could be made of anonconductive material (such as plastic) and the sensor may be connectedto or disposed in the surgical staple cartridge 12534, as describedabove.

It should be noted that although the embodiments of the surgical tool12500 described herein employ a surgical end effector 12512 that staplesthe severed tissue, in other embodiments different techniques forfastening or sealing the severed tissue may be used. For example, endeffectors that use RF energy or adhesives to fasten the severed tissuemay also be used. U.S. Pat. No. 5,709,680, entitled ELECTROSURGICALHEMOSTATIC DEVICE to Yates et al., and U.S. Pat. No. 5,688,270, entitledELECTROSURGICAL HEMOSTATIC DEVICE WITH RECESSED AND/OR OFFSET ELECTRODESto Yates et al., which are incorporated herein by reference, disclosescutting instruments that use RF energy to fasten the severed tissue.U.S. patent application Ser. No. 11/267,811 to Morgan et al. now U.S.Pat. No. 7,673,783, and U.S. patent application Ser. No. 11/267,383 toShelton et al., now U.S. Pat. No. 7,607,557, which are also incorporatedherein by reference, disclose cutting instruments that use adhesives tofasten the severed tissue. Accordingly, although the description hereinrefers to cutting/stapling operations and the like, it should berecognized that this is an exemplary embodiment and is not meant to belimiting. Other tissue-fastening techniques may also be used.

In the illustrated embodiment, the elongated channel 12522 of thesurgical end effector 12512 is coupled to an elongated shaft assembly12508 that is coupled to a tool mounting portion 12600. In at least oneembodiment, the elongated shaft assembly 12508 comprises a hollow spinetube 12540 that is non-movably coupled to a tool mounting plate 12602 ofthe tool mounting portion 12600. As can be seen in FIGS. 81 and 82, theproximal end 12523 of the elongated channel 12522 comprises a hollowtubular structure configured to be attached to the distal end 12541 ofthe spine tube 12540. In one embodiment, for example, the proximal end12523 of the elongated channel 12522 is welded or glued to the distalend of the spine tube 12540.

As can be further seen in FIGS. 81 and 82, in at least one non-limitingembodiment, the surgical tool 12500 further includes an axially movableactuation member in the form of a closure tube 12550 that is constrainedto move axially relative to the elongated channel 12522 and the spinetube 11540. The closure tube 12550 has a proximal end 12552 that has aninternal thread 12554 formed therein that is in threaded engagement witha rotatably movable portion in the form of a closure drive nut 12560.More specifically, the closure drive nut 12560 has a proximal endportion 12562 that is rotatably supported relative to the elongatedchannel 12522 and the spine tube 12540. For assembly purposes, theproximal end portion 12562 is threadably attached to a retention ring12570. The retention ring 12570 is received in a groove 12529 formedbetween a shoulder 12527 on the proximal end 12523 of the elongatedchannel 12522 and the distal end 12541 of the spine tube 11540. Sucharrangement serves to rotatably support the closure drive nut 12560within the elongated channel 12522. Rotation of the closure drive nut12560 will cause the closure tube 12550 to move axially as representedby arrow “D” in FIG. 81.

Extending through the spine tube 12540 and the closure drive nut 12560is a drive member which, in at least one embodiment, comprises a knifebar 12580 that has a distal end portion 12582 that is rotatably coupledto the cutting instrument 12532 such that the knife bar 12580 may rotaterelative to the cutting instrument 12582. As can be seen in FIG. 81-83,the closure drive nut 12560 has a slot 12564 therein through which theknife bar 12580 can slidably extend. Such arrangement permits the knifebar 12580 to move axially relative to the closure drive nut 12560.However, rotation of the knife bar 12580 about the longitudinal toolaxis LT-LT will also result in the rotation of the closure drive nut12560. The axial direction in which the closure tube 12550 movesultimately depends upon the direction in which the knife bar 12580 andthe closure drive nut 12560 are rotated. As the closure tube 12550 isdriven distally, the distal end thereof will contact the anvil 12524 andcause the anvil 12524 to pivot to a closed position. Upon application ofan opening rotary output motion from the robotic system 11000, theclosure tube 12550 will be driven in the proximal direction “PD” andpivot the anvil 12524 to the open position by virtue of the engagementof the tab 12527 with the opening 12555 in the closure tube 12550.

In use, it may be desirable to rotate the surgical end effector 12512about the longitudinal tool axis LT-LT. In at least one embodiment, thetool mounting portion 12600 is configured to receive a correspondingfirst rotary output motion from the robotic system 11000 and convertthat first rotary output motion to a rotary control motion for rotatingthe elongated shaft assembly 12508 about the longitudinal tool axisLT-LT. As can be seen in FIG. 79, a proximal end 12542 of the hollowspine tube 12540 is rotatably supported within a cradle arrangement12603 attached to a tool mounting plate 12602 of the tool mountingportion 12600. Various embodiments of the surgical tool 12500 furtherinclude a transmission arrangement, generally depicted as 12605, that isoperably supported on the tool mounting plate 12602. In various formsthe transmission arrangement 12605 include a rotation gear 12544 that isformed on or attached to the proximal end 12542 of the spine tube 12540for meshing engagement with a rotation drive assembly 12610 that isoperably supported on the tool mounting plate 12602. In at least oneembodiment, a rotation drive gear 12612 is coupled to a correspondingfirst one of the rotational bodies, driven discs or elements 11304 onthe adapter side of the tool mounting plate 12602 when the tool mountingportion 12600 is coupled to the tool holder 11270. See FIGS. 63 and 84.The rotation drive assembly 12610 further comprises a rotary driven gear12614 that is rotatably supported on the tool mounting plate 12602 inmeshing engagement with the rotation gear 12544 and the rotation drivegear 12612. Application of a first rotary output motion from the roboticsystem 11000 through the tool drive assembly 11010 to the correspondingdriven rotational body 11304 will thereby cause rotation of the rotationdrive gear 12612 by virtue of being operably coupled thereto. Rotationof the rotation drive gear 12612 ultimately results in the rotation ofthe elongated shaft assembly 12508 (and the end effector 12512) aboutthe longitudinal tool axis LT-LT.

Closure of the anvil 12524 relative to the surgical staple cartridge12534 is accomplished by axially moving the closure tube 12550 in thedistal direction “DD”. Axial movement of the closure tube 12550 in thedistal direction “DD” is accomplished by applying a rotary controlmotion to the closure drive nut 12382. In various embodiments, theclosure drive nut 12560 is rotated by applying a rotary output motion tothe knife bar 12580. Rotation of the knife bar 12580 is controlled byapplying rotary output motions to a rotary closure system 12620 that isoperably supported on the tool mounting plate 12602 as shown in FIG. 84.In at least one embodiment, the rotary closure system 12620 includes aclosure drive gear 12622 that is coupled to a corresponding second oneof the driven rotatable body portions discs or elements 11304 on theadapter side of the tool mounting plate 12462 when the tool mountingportion 12600 is coupled to the tool holder 11270. See FIGS. 63 and 84.The closure drive gear 12622, in at least one embodiment, is in meshingdriving engagement with a closure gear train, generally depicted as12623. The closure gear drive train 12623 comprises a first drivenclosure gear 12624 that is rotatably supported on the tool mountingplate 12602. The first closure driven gear 12624 is attached to a secondclosure driven gear 12626 by a drive shaft 12628. The second closuredriven gear 12626 is in meshing engagement with a third closure drivengear 12630 that is rotatably supported on the tool mounting plate 12602.Rotation of the closure drive gear 12622 in a second rotary directionwill result in the rotation of the third closure driven gear 12630 in asecond direction. Conversely, rotation of the closure drive gear 12483in a secondary rotary direction (opposite to the second rotarydirection) will cause the third closure driven gear 12630 to rotate in asecondary direction.

As can be seen in FIG. 84, a drive shaft assembly 12640 is coupled to aproximal end of the knife bar 12580. In various embodiments, the driveshaft assembly 12640 includes a proximal portion 12642 that has a squarecross-sectional shape. The proximal portion 12642 is configured toslideably engage a correspondingly shaped aperture in the third drivengear 12630. Such arrangement results in the rotation of the drive shaftassembly 12640 (and knife bar 12580) when the third driven gear 12630 isrotated. The drive shaft assembly 12640 is axially advanced in thedistal and proximal directions by a knife drive assembly 12650. One formof the knife drive assembly 12650 comprises a rotary drive gear 12652that is coupled to a corresponding third one of the driven rotatablebody portions, discs or elements 11304 on the adapter side of the toolmounting plate 12462 when the tool mounting portion 12600 is coupled tothe tool holder 11270. See FIGS. 63 and 84. The rotary driven gear 12652is in meshing driving engagement with a gear train, generally depictedas 12653. In at least one form, the gear train 12653 further comprises afirst rotary driven gear assembly 12654 that is rotatably supported onthe tool mounting plate 12602. The first rotary driven gear assembly12654 is in meshing engagement with a third rotary driven gear assembly12656 that is rotatably supported on the tool mounting plate 12602 andwhich is in meshing engagement with a fourth rotary driven gear assembly12658 that is in meshing engagement with a threaded portion 12644 of thedrive shaft assembly 12640. Rotation of the rotary drive gear 12652 in athird rotary direction will result in the axial advancement of the driveshaft assembly 12640 and knife bar 12580 in the distal direction “DD”.Conversely, rotation of the rotary drive gear 12652 in a tertiary rotarydirection (opposite to the third rotary direction) will cause the driveshaft assembly 12640 and the knife bar 12580 to move in the proximaldirection.

A method of operating the surgical tool 12500 will now be described.Once the tool mounting portion 12600 has been operably coupled to thetool holder 11270 of the robotic system 11000, the robotic system 11000can orient the surgical end effector 12512 in position adjacent thetarget tissue to be cut and stapled. If the anvil 12524 is not alreadyin the open position (FIG. 81), the robotic system 11000 may apply thesecond rotary output motion to the closure drive gear 12622 whichresults in the rotation of the knife bar 12580 in a second direction.Rotation of the knife bar 12580 in the second direction results in therotation of the closure drive nut 12560 in a second direction. As theclosure drive nut 12560 rotates in the second direction, the closuretube 12550 moves in the proximal direction “PD”. As the closure tube12550 moves in the proximal direction “PD”, the tab 12527 on the anvil12524 interfaces with the opening 12555 in the closure tube 12550 andcauses the anvil 12524 to pivot to the open position. In addition or inalternative embodiments, a spring (not shown) may be employed to pivotthe anvil 12354 to the open position when the closure tube 12550 hasbeen returned to the starting position (FIG. 81). The opened surgicalend effector 12512 may then be manipulated by the robotic system 11000to position the target tissue between the open anvil 12524 and thesurgical staple cartridge 12534. Thereafter, the surgeon may initiatethe closure process by activating the robotic control system 11000 toapply the second rotary output motion to the closure drive gear 12622which, as was described above, ultimately results in the rotation of theclosure drive nut 12382 in the second direction which results in theaxial travel of the closure tube 12250 in the distal direction “DD”. Asthe closure tube 12550 moves in the distal direction, it contacts aportion of the anvil 12524 and causes the anvil 12524 to pivot to theclosed position to clamp the target tissue between the anvil 12524 andthe staple cartridge 12534. Once the robotic controller 11001 determinesthat the anvil 12524 has been pivoted to the closed position bycorresponding sensor(s) in the end effector 12512 that are incommunication therewith, the robotic controller 11001 discontinues theapplication of the second rotary output motion to the closure drive gear12622. The robotic controller 11001 may also provide the surgeon with anindication that the anvil 12524 has been fully closed. The surgeon maythen initiate the firing procedure. In alternative embodiments, thefiring procedure may be automatically initiated by the roboticcontroller 11001.

After the robotic controller 11001 has determined that the anvil 12524is in the closed position, the robotic controller 11001 then applies thethird rotary output motion to the rotary drive gear 12652 which resultsin the axial movement of the drive shaft assembly 12640 and knife bar12580 in the distal direction “DD”. As the cutting instrument 12532moves distally through the surgical staple cartridge 12534, the tissueclamped therein is severed. As the sled portion (not shown) is drivendistally, it causes the staples within the surgical staple cartridge12534 to be driven through the severed tissue into forming contact withthe anvil 12524. Once the robotic controller 11001 has determined thatthe cutting instrument 12532 has reached the end position within thesurgical staple cartridge 12534 by means of sensor(s) in the surgicalend effector 12512 that are in communication with the robotic controller11001, the robotic controller 11001 discontinues the application of thesecond rotary output motion to the rotary drive gear 12652. Thereafter,the robotic controller 11001 applies the secondary rotary control motionto the rotary drive gear 12652 which ultimately results in the axialtravel of the cutting instrument 12532 and sled portion in the proximaldirection “PD” to the starting position. Once the robotic controller11001 has determined that the cutting instrument 12524 has reached thestarting position by means of sensor(s) in the end effector 12512 thatare in communication with the robotic controller 11001, the roboticcontroller 11001 discontinues the application of the secondary rotaryoutput motion to the rotary drive gear 12652. Thereafter, the roboticcontroller 11001 may apply the secondary rotary output motion to theclosure drive gear 12622 which results in the rotation of the knife bar12580 in a secondary direction. Rotation of the knife bar 12580 in thesecondary direction results in the rotation of the closure drive nut12560 in a secondary direction. As the closure drive nut 12560 rotatesin the secondary direction, the closure tube 12550 moves in the proximaldirection “PD” to the open position.

FIGS. 85-90B illustrate yet another surgical tool 12700 that may beeffectively employed in connection with the robotic system 11000. Invarious forms, the surgical tool 12700 includes a surgical end effector12712 that includes a “first portion” in the form of an elongatedchannel 12722 and a “second movable portion” comprising a pivotallytranslatable clamping member, such as an anvil 12724, which aremaintained at a spacing that assures effective stapling and severing oftissue clamped in the surgical end effector 12712. As shown in theillustrated embodiment, the surgical end effector 12712 may include, inaddition to the previously-mentioned channel 12722 and anvil 12724, a“third movable portion” in the form of a cutting instrument 12732, asled (not shown), and a surgical staple cartridge 12734 that isremovably seated in the elongated channel 12722. The cutting instrument12732 may be, for example, a knife. The anvil 12724 may be pivotablyopened and closed at a pivot point 12725 connected to the proximal endof the elongated channel 12722. The anvil 12724 may also include a tab12727 at its proximal end that interfaces with a component of themechanical closure system (described further below) to open and closethe anvil 12724. When actuated, the knife 12732 and sled to travellongitudinally along the elongated channel 12722, thereby cutting tissueclamped within the surgical end effector 12712. The movement of the sledalong the elongated channel 12722 causes the staples of the surgicalstaple cartridge 12734 to be driven through the severed tissue andagainst the closed anvil 12724, which turns the staples to fasten thesevered tissue. In one form, the elongated channel 12722 and the anvil12724 may be made of an electrically conductive material (such as metal)so that they may serve as part of the antenna that communicates withsensor(s) in the surgical end effector, as described above. The surgicalstaple cartridge 12734 could be made of a nonconductive material (suchas plastic) and the sensor may be connected to or disposed in thesurgical staple cartridge 12734, as described above.

It should be noted that although the embodiments of the surgical tool12500 described herein employ a surgical end effector 12712 that staplesthe severed tissue, in other embodiments different techniques forfastening or sealing the severed tissue may be used. For example, endeffectors that use RF energy or adhesives to fasten the severed tissuemay also be used. U.S. Pat. No. 5,709,680, entitled ELECTROSURGICALHEMOSTATIC DEVICE to Yates et al., and U.S. Pat. No. 5,688,270, entitledELECTROSURGICAL HEMOSTATIC DEVICE WITH RECESSED AND/OR OFFSET ELECTRODESto Yates et al., which are incorporated herein by reference, disclosescutting instruments that use RF energy to fasten the severed tissue.U.S. patent application Ser. No. 11/267,811 to Morgan et al., now U.S.Pat. No. 7,673,783, and U.S. patent application Ser. No. 11/267,383 toShelton et al., now U.S. Pat. No. 7,607,557, which are also incorporatedherein by reference, disclose cutting instruments that use adhesives tofasten the severed tissue. Accordingly, although the description hereinrefers to cutting/stapling operations and the like, it should berecognized that this is an exemplary embodiment and is not meant to belimiting. Other tissue-fastening techniques may also be used.

In the illustrated embodiment, the elongated channel 12722 of thesurgical end effector 12712 is coupled to an elongated shaft assembly12708 that is coupled to a tool mounting portion 12900. Although notshown, the elongated shaft assembly 12708 may include an articulationjoint to permit the surgical end effector 12712 to be selectivelyarticulated about an axis that is substantially transverse to the toolaxis LT-LT. In at least one embodiment, the elongated shaft assembly12708 comprises a hollow spine tube 12740 that is non-movably coupled toa tool mounting plate 12902 of the tool mounting portion 12900. As canbe seen in FIGS. 86 and 87, the proximal end 12723 of the elongatedchannel 12722 comprises a hollow tubular structure that is attached tothe spine tube 12740 by means of a mounting collar 12790. Across-sectional view of the mounting collar 12790 is shown in FIG. 88.In various embodiments, the mounting collar 12790 has a proximal flangedend 12791 that is configured for attachment to the distal end of thespine tube 12740. In at least one embodiment, for example, the proximalflanged end 12791 of the mounting collar 12790 is welded or glued to thedistal end of the spine tube 12740. As can be further seen in FIGS. 86and 87, the mounting collar 12790 further has a mounting hub portion12792 that is sized to receive the proximal end 12723 of the elongatedchannel 12722 thereon. The proximal end 12723 of the elongated channel12722 is non-movably attached to the mounting hub portion 12792 by, forexample, welding, adhesive, etc.

As can be further seen in FIGS. 86 and 87, the surgical tool 12700further includes an axially movable actuation member in the form of aclosure tube 12750 that is constrained to move axially relative to theelongated channel 12722. The closure tube 12750 has a proximal end 12752that has an internal thread 12754 formed therein that is in threadedengagement with a rotatably movable portion in the form of a closuredrive nut 12760. More specifically, the closure drive nut 12760 has aproximal end portion 12762 that is rotatably supported relative to theelongated channel 12722 and the spine tube 12740. For assembly purposes,the proximal end portion 12762 is threadably attached to a retentionring 12770. The retention ring 12770 is received in a groove 12729formed between a shoulder 12727 on the proximal end 12723 of the channel12722 and the mounting hub 12729 of the mounting collar 12790. Sucharrangement serves to rotatably support the closure drive nut 12760within the channel 12722. Rotation of the closure drive nut 12760 willcause the closure tube 12750 to move axially as represented by arrow “D”in FIG. 86.

Extending through the spine tube 12740, the mounting collar 12790, andthe closure drive nut 12760 is a drive member, which in at least oneembodiment, comprises a knife bar 12780 that has a distal end portion12782 that is coupled to the cutting instrument 12732. As can be seen inFIGS. 86 and 87, the mounting collar 12790 has a passage 12793therethrough for permitting the knife bar 12780 to slidably passtherethrough. Similarly, the closure drive nut 12760 has a slot 12764therein through which the knife bar 12780 can slidably extend. Sucharrangement permits the knife bar 12780 to move axially relative to theclosure drive nut 12760.

Actuation of the anvil 12724 is controlled by a rotary driven closureshaft 12800. As can be seen in FIGS. 86 and 87, a distal end portion12802 of the closure drive shaft 12800 extends through a passage 12794in the mounting collar 12790 and a closure gear 12804 is attachedthereto. The closure gear 12804 is configured for driving engagementwith the inner surface 12761 of the closure drive nut 12760. Thus,rotation of the closure shaft 12800 will also result in the rotation ofthe closure drive nut 12760. The axial direction in which the closuretube 12750 moves ultimately depends upon the direction in which theclosure shaft 12800 and the closure drive nut 12760 are rotated. Forexample, in response to one rotary closure motion received from therobotic system 11000, the closure tube 12750 will be driven in thedistal direction “DD”. As the closure tube 12750 is driven distally, theopening 12745 will engage the tab 12727 on the anvil 12724 and cause theanvil 12724 to pivot to a closed position. Upon application of anopening rotary motion from the robotic system 11000, the closure tube12750 will be driven in the proximal direction “PD” and pivot the anvil12724 to the open position. In various embodiments, a spring (not shown)may be employed to bias the anvil 12724 to the open position (FIG. 86).

In use, it may be desirable to rotate the surgical end effector 12712about the longitudinal tool axis LT-LT. In at least one embodiment, thetool mounting portion 12900 is configured to receive a correspondingfirst rotary output motion from the robotic system 11000 for rotatingthe elongated shaft assembly 12708 about the tool axis LT-LT. As can beseen in FIG. 90, a proximal end 12742 of the hollow spine tube 12740 isrotatably supported within a cradle arrangement 12903 and a bearingassembly 12904 that are attached to a tool mounting plate 12902 of thetool mounting portion 12900. A rotation gear 12744 is formed on orattached to the proximal end 12742 of the spine tube 12740 for meshingengagement with a rotation drive assembly 12910 that is operablysupported on the tool mounting plate 12902. In at least one embodiment,a rotation drive gear 12912 is coupled to a corresponding first one ofthe driven discs or elements 11304 on the adapter side of the toolmounting plate 12602 when the tool mounting portion 12600 is coupled tothe tool holder 11270. See FIGS. 63 and 90. The rotation drive assembly12910 further comprises a rotary driven gear 12914 that is rotatablysupported on the tool mounting plate 12902 in meshing engagement withthe rotation gear 12744 and the rotation drive gear 12912. Applicationof a first rotary control motion from the robotic system 11000 throughthe tool holder 11270 and the adapter 11240 to the corresponding drivenelement 11304 will thereby cause rotation of the rotation drive gear12912 by virtue of being operably coupled thereto. Rotation of therotation drive gear 12912 ultimately results in the rotation of theelongated shaft assembly 12708 (and the end effector 12712) about thelongitudinal tool axis LT-LT (primary rotary motion).

Closure of the anvil 12724 relative to the staple cartridge 12734 isaccomplished by axially moving the closure tube 12750 in the distaldirection “DD”. Axial movement of the closure tube 12750 in the distaldirection “DD” is accomplished by applying a rotary control motion tothe closure drive nut 12760. In various embodiments, the closure drivenut 12760 is rotated by applying a rotary output motion to the closuredrive shaft 12800. As can be seen in FIG. 90, a proximal end portion12806 of the closure drive shaft 12800 has a driven gear 12808 thereonthat is in meshing engagement with a closure drive assembly 12920. Invarious embodiments, the closure drive system 12920 includes a closuredrive gear 12922 that is coupled to a corresponding second one of thedriven rotational bodies or elements 11304 on the adapter side of thetool mounting plate 12462 when the tool mounting portion 12900 iscoupled to the tool holder 11270. See FIGS. 63 and 90. The closure drivegear 12922 is supported in meshing engagement with a closure gear train,generally depicted as 12923. In at least one form, the closure gear rain12923 comprises a first driven closure gear 12924 that is rotatablysupported on the tool mounting plate 12902. The first closure drivengear 12924 is attached to a second closure driven gear 12926 by a driveshaft 12928. The second closure driven gear 12926 is in meshingengagement with a planetary gear assembly 12930. In various embodiments,the planetary gear assembly 12930 includes a driven planetary closuregear 12932 that is rotatably supported within the bearing assembly 12904that is mounted on tool mounting plate 12902. As can be seen in FIGS. 90and 90B, the proximal end portion 12806 of the closure drive shaft 12800is rotatably supported within the proximal end portion 12742 of thespine tube 12740 such that the driven gear 12808 is in meshingengagement with central gear teeth 12934 formed on the planetary gear12932. As can also be seen in FIG. 90A, two additional support gears12936 are attached to or rotatably supported relative to the proximalend portion 12742 of the spine tube 12740 to provide bearing supportthereto. Such arrangement with the planetary gear assembly 12930 servesto accommodate rotation of the spine shaft 12740 by the rotation driveassembly 12910 while permitting the closure driven gear 12808 to remainin meshing engagement with the closure drive system 12920. In addition,rotation of the closure drive gear 12922 in a first direction willultimately result in the rotation of the closure drive shaft 12800 andclosure drive nut 12760 which will ultimately result in the closure ofthe anvil 12724 as described above. Conversely, rotation of the closuredrive gear 12922 in a second opposite direction will ultimately resultin the rotation of the closure drive nut 12760 in an opposite directionwhich results in the opening of the anvil 12724.

As can be seen in FIG. 84, the proximal end 12784 of the knife bar 12780has a threaded shaft portion 12786 attached thereto which is in drivingengagement with a knife drive assembly 12940. In various embodiments,the threaded shaft portion 12786 is rotatably supported by a bearing12906 attached to the tool mounting plate 12902. Such arrangementpermits the threaded shaft portion 12786 to rotate and move axiallyrelative to the tool mounting plate 12902. The knife bar 12780 isaxially advanced in the distal and proximal directions by the knifedrive assembly 12940. One form of the knife drive assembly 12940comprises a rotary drive gear 12942 that is coupled to a correspondingthird one of the rotatable bodies, driven discs or elements 11304 on theadapter side of the tool mounting plate 12902 when the tool mountingportion 12900 is coupled to the tool holder 11270. See FIGS. 63 and 90.The rotary drive gear 12942 is in meshing engagement with a knife geartrain, generally depicted as 12943. In various embodiments, the knifegear train 12943 comprises a first rotary driven gear assembly 12944that is rotatably supported on the tool mounting plate 12902. The firstrotary driven gear assembly 12944 is in meshing engagement with a thirdrotary driven gear assembly 12946 that is rotatably supported on thetool mounting plate 12902 and which is in meshing engagement with afourth rotary driven gear assembly 12948 that is in meshing engagementwith the threaded portion 12786 of the knife bar 12780. Rotation of therotary drive gear 12942 in one direction will result in the axialadvancement of the knife bar 12780 in the distal direction “DD”.Conversely, rotation of the rotary drive gear 12942 in an oppositedirection will cause the knife bar 12780 to move in the proximaldirection. Tool 12700 may otherwise be used as described above.

FIGS. 91 and 92 illustrate a surgical tool embodiment 12700′ that issubstantially identical to tool 12700 that was described in detailabove. However tool 12700′ includes a pressure sensor 12950 that isconfigured to provide feedback to the robotic controller 11001concerning the amount of clamping pressure experienced by the anvil12724. In various embodiments, for example, the pressure sensor maycomprise a spring biased contact switch. For a continuous signal, itwould use either a cantilever beam with a strain gage on it or a domebutton top with a strain gage on the inside. Another version maycomprise an off switch that contacts only at a known desired load. Sucharrangement would include a dome on the base wherein the dome is oneelectrical pole and the base is the other electrical pole. Sucharrangement permits the robotic controller 11001 to adjust the amount ofclamping pressure being applied to the tissue within the surgical endeffector 12712 by adjusting the amount of closing pressure applied tothe anvil 12724. Those of ordinary skill in the art will understand thatsuch pressure sensor arrangement may be effectively employed withseveral of the surgical tool embodiments described herein as well astheir equivalent structures.

FIG. 93 illustrates a portion of another surgical tool 3000 that may beeffectively used in connection with a robotic system 11000. The surgicaltool 3003 employs on-board motor(s) for powering various components of asurgical end effector cutting instrument. In at least one non-limitingembodiment for example, the surgical tool 3000 includes a surgical endeffector in the form of an endocutter (not shown) that has an anvil (notshown) and surgical staple cartridge arrangement (not shown) of thetypes and constructions described above. The surgical tool 3000 alsoincludes an elongated shaft (not shown) and anvil closure arrangement(not shown) of the types described above. Thus, this portion of theDetailed Description will not repeat the description of those componentsbeyond that which is necessary to appreciate the unique and novelattributes of the various embodiments of surgical tool 3000.

In the depicted embodiment, the end effector includes a cuttinginstrument 3002 that is coupled to a knife bar 3003. As can be seen inFIG. 93, the surgical tool 3000 includes a tool mounting portion 3010that includes a tool mounting plate 3012 that is configured tomountingly interface with the adaptor portion 11240′ which is coupled tothe robotic system 11000 in the various manners described above. Thetool mounting portion 3010 is configured to operably support atransmission arrangement 3013 thereon. In at least one embodiment, theadaptor portion 11240′ may be identical to the adaptor portion 11240described in detail above without the powered rotation bodies and discmembers employed by adapter 11240. In other embodiments, the adaptorportion 11240′ may be identical to adaptor portion 11240. Still othermodifications which are considered to be within the spirit and scope ofthe various forms of the present invention may employ one or more of themechanical motions (i.e., rotary motion(s)) from the tool holder portion11270 (as described hereinabove) to power/actuate the transmissionarrangement 3013 while also employing one or more motors within the toolmounting portion 3010 to power one or more other components of thesurgical end effector. In addition, while the end effector of thedepicted embodiment comprises an endocutter, those of ordinary skill inthe art will understand that the unique and novel attributes of thedepicted embodiment may be effectively employed in connection with othertypes of surgical end effectors without departing from the spirit andscope of various forms of the present invention.

In various embodiments, the tool mounting plate 3012 is configured to atleast house a first firing motor 3011 for supplying firing andretraction motions to the knife bar 3003 which is coupled to orotherwise operably interfaces with the cutting instrument 3002. The toolmounting plate 3012 has an array of electrical connecting pins 3014which are configured to interface with the slots 11258 (FIG. 62) in theadapter 11240′. Such arrangement permits the controller 11001 of therobotic system 11000 to provide control signals to the electroniccontrol circuit 3020 of the surgical tool 3000. While the interface isdescribed herein with reference to mechanical, electrical, and magneticcoupling elements, it should be understood that a wide variety oftelemetry modalities might be used, including infrared, inductivecoupling, or the like.

Control circuit 3020 is shown in schematic form in FIG. 93. In one formor embodiment, the control circuit 3020 includes a power supply in theform of a battery 3022 that is coupled to an on-off solenoid poweredswitch 3024. Control circuit 3020 further includes an on/off firingsolenoid 3026 that is coupled to a double pole switch 3028 forcontrolling the rotational direction of the motor 3011. Thus, when thecontroller 11001 of the robotic system 11000 supplies an appropriatecontrol signal, switch 3024 will permit battery 3022 to supply power tothe double pole switch 3028. The controller 11001 of the robotic system11000 will also supply an appropriate signal to the double pole switch3028 to supply power to the motor 3011. When it is desired to fire thesurgical end effector (i.e., drive the cutting instrument 3002 distallythrough tissue clamped in the surgical end effector) the double poleswitch 3028 will be in a first position. When it is desired to retractthe cutting instrument 3002 to the starting position, the double poleswitch 3028 will be moved to the second position by the controller11001.

Various embodiments of the surgical tool 3000 also employ a gear box3030 that is sized, in cooperation with a firing gear train 3031 that,in at least one non-limiting embodiment, comprises a firing drive gear3032 that is in meshing engagement with a firing driven gear 3034 forgenerating a desired amount of driving force necessary to drive thecutting instrument 3002 through tissue and to drive and form staples inthe various manners described herein. In the embodiment depicted in FIG.93, the driven gear 3034 is coupled to a screw shaft 3036 that is inthreaded engagement with a screw nut arrangement 3038 that isconstrained to move axially (represented by arrow “D”). The screw nutarrangement 3038 is attached to the firing bar 3003. Thus, by rotatingthe screw shaft 3036 in a first direction, the cutting instrument 3002is driven in the distal direction “DD” and rotating the screw shaft inan opposite second direction, the cutting instrument 3002 may beretracted in the proximal direction “PD”.

FIG. 94 illustrates a portion of another surgical tool 3000′ that issubstantially identical to tool 3000 described above, except that thedriven gear 3034 is attached to a drive shaft 3040. The drive shaft 3040is attached to a second driver gear 3042 that is in meshing engagementwith a third driven gear 3044 that is in meshing engagement with a screw3046 coupled to the firing bar 3003.

FIG. 95 illustrates another surgical tool 3200 that may be effectivelyused in connection with a robotic system 11000. In this embodiment, thesurgical tool 3200 includes a surgical end effector 3212 that in onenon-limiting form, comprises a component portion that is selectivelymovable between first and second positions relative to at least oneother end effector component portion. As will be discussed in furtherdetail below, the surgical tool 3200 employs on-board motors forpowering various components of a transmission arrangement 3305. Thesurgical end effector 3212 includes an elongated channel 3222 thatoperably supports a surgical staple cartridge 3234. The elongatedchannel 3222 has a proximal end 3223 that slidably extends into a hollowelongated shaft assembly 3208 that is coupled to a tool mounting portion3300. In addition, the surgical end effector 3212 includes an anvil 3224that is pivotally coupled to the elongated channel 3222 by a pair oftrunnions 3225 that are received within corresponding openings 3229 inthe elongated channel 3222. A distal end portion 3209 of the shaftassembly 3208 includes an opening 3245 into which a tab 3227 on theanvil 3224 is inserted in order to open the anvil 3224 as the elongatedchannel 3222 is moved axially in the proximal direction “PD” relative tothe distal end portion 3209 of the shaft assembly 3208. In variousembodiments, a spring (not shown) may be employed to bias the anvil 3224to the open position.

As indicated above, the surgical tool 3200 includes a tool mountingportion 3300 that includes a tool mounting plate 3302 that is configuredto operably support the transmission arrangement 3305 and to mountinglyinterface with the adaptor portion 11240′ which is coupled to therobotic system 11000 in the various manners described above. In at leastone embodiment, the adaptor portion 11240′ may be identical to theadaptor portion 11240 described in detail above without the powered discmembers employed by adapter 11240. In other embodiments, the adaptorportion 11240′ may be identical to adaptor portion 11240. However, insuch embodiments, because the various components of the surgical endeffector 3212 are all powered by motor(s) in the tool mounting portion3300, the surgical tool 3200 will not employ or require any of themechanical (i.e., non-electrical) actuation motions from the tool holderportion 11270 to power the surgical end effector 3200 components. Stillother modifications which are considered to be within the spirit andscope of the various forms of the present invention may employ one ormore of the mechanical motions from the tool holder portion 11270 (asdescribed hereinabove) to power/actuate one or more of the surgical endeffector components while also employing one or more motors within thetool mounting portion to power one or more other components of thesurgical end effector.

In various embodiments, the tool mounting plate 3302 is configured tosupport a first firing motor 3310 for supplying firing and retractionmotions to the transmission arrangement 3305 to drive a knife bar 3335that is coupled to a cutting instrument 3332 of the type describedabove. As can be seen in FIG. 95, the tool mounting plate 3212 has anarray of electrical connecting pins 3014 which are configured tointerface with the slots 11258 (FIG. 62) in the adapter 11240′. Sucharrangement permits the controller 11001 of the robotic system 11000 toprovide control signals to the electronic control circuits 3320, 3340 ofthe surgical tool 3200. While the interface is described herein withreference to mechanical, electrical, and magnetic coupling elements, itshould be understood that a wide variety of telemetry modalities mightbe used, including infrared, inductive coupling, or the like.

In one form or embodiment, the first control circuit 3320 includes afirst power supply in the form of a first battery 3322 that is coupledto a first on-off solenoid powered switch 3324. The first firing controlcircuit 3320 further includes a first on/off firing solenoid 3326 thatis coupled to a first double pole switch 3328 for controlling therotational direction of the first firing motor 3310. Thus, when therobotic controller 11001 supplies an appropriate control signal, thefirst switch 3324 will permit the first battery 3322 to supply power tothe first double pole switch 3328. The robotic controller 11001 willalso supply an appropriate signal to the first double pole switch 3328to supply power to the first firing motor 3310. When it is desired tofire the surgical end effector (i.e., drive the cutting instrument 3232distally through tissue clamped in the surgical end effector 3212, thefirst switch 3328 will be positioned in a first position by the roboticcontroller 11001. When it is desired to retract the cutting instrument3232 to the starting position, the robotic controller 11001 will sendthe appropriate control signal to move the first switch 3328 to thesecond position.

Various embodiments of the surgical tool 3200 also employ a first gearbox 3330 that is sized, in cooperation with a firing drive gear 3332coupled thereto that operably interfaces with a firing gear train 3333.In at least one non-limiting embodiment, the firing gear train 333comprises a firing driven gear 3334 that is in meshing engagement withdrive gear 3332, for generating a desired amount of driving forcenecessary to drive the cutting instrument 3232 through tissue and todrive and form staples in the various manners described herein. In theembodiment depicted in FIG. 95, the driven gear 3334 is coupled to adrive shaft 3335 that has a second driven gear 3336 coupled thereto. Thesecond driven gear 3336 is supported in meshing engagement with a thirddriven gear 3337 that is in meshing engagement with a fourth driven gear3338. The fourth driven gear 3338 is in meshing engagement with athreaded proximal portion 3339 of the knife bar 3235 that is constrainedto move axially. Thus, by rotating the drive shaft 3335 in a firstdirection, the cutting instrument 3232 is driven in the distal direction“DD” and rotating the drive shaft 3335 in an opposite second direction,the cutting instrument 3232 may be retracted in the proximal direction“PD”.

As indicated above, the opening and closing of the anvil 3224 iscontrolled by axially moving the elongated channel 3222 relative to theelongated shaft assembly 3208. The axial movement of the elongatedchannel 3222 is controlled by a closure control system 3339. In variousembodiments, the closure control system 3339 includes a closure shaft3340 which has a hollow threaded end portion 3341 that threadablyengages a threaded closure rod 3342. The threaded end portion 3341 isrotatably supported in a spine shaft 3343 that operably interfaces withthe tool mounting portion 3300 and extends through a portion of theshaft assembly 3208 as shown. The closure system 3339 further comprisesa closure control circuit 3350 that includes a second power supply inthe form of a second battery 3352 that is coupled to a second on-offsolenoid powered switch 3354. Closure control circuit 3350 furtherincludes a second on/off firing solenoid 3356 that is coupled to asecond double pole switch 3358 for controlling the rotation of a secondclosure motor 3360. Thus, when the robotic controller 11001 supplies anappropriate control signal, the second switch 3354 will permit thesecond battery 3352 to supply power to the second double pole switch3354. The robotic controller 11001 will also supply an appropriatesignal to the second double pole switch 3358 to supply power to thesecond motor 3360. When it is desired to close the anvil 3224, thesecond switch 3348 will be in a first position. When it is desired toopen the anvil 3224, the second switch 3348 will be moved to a secondposition.

Various embodiments of tool mounting portion 3300 also employ a secondgear box 3362 that is coupled to a closure drive gear 3364. The closuredrive gear 3364 is in meshing engagement with a closure gear train 3363.In various non-limiting forms, the closure gear train 3363 includes aclosure driven gear 3365 that is attached to a closure drive shaft 3366.Also attached to the closure drive shaft 3366 is a closure drive gear3367 that is in meshing engagement with a closure shaft gear 3360attached to the closure shaft 3340. FIG. 95 depicts the end effector3212 in the open position. As indicated above, when the threaded closurerod 3342 is in the position depicted in FIG. 95, a spring (not shown)biases the anvil 3224 to the open position. When it is desired to closethe anvil 3224, the robotic controller 11001 will activate the secondmotor 3360 to rotate the closure shaft 3340 to draw the threaded closurerod 3342 and the channel 3222 in the proximal direction ‘PD’. As theanvil 3224 contacts the distal end portion 3209 of the shaft 3208, theanvil 3224 is pivoted to the closed position.

A method of operating the surgical tool 3200 will now be described. Oncethe tool mounting portion 3302 has been operably coupled to the toolholder 11270 of the robotic system 11000, the robotic system 11000 canorient the end effector 3212 in position adjacent the target tissue tobe cut and stapled. If the anvil 3224 is not already in the openposition, the robotic controller 11001 may activate the second closuremotor 3360 to drive the channel 3222 in the distal direction to theposition depicted in FIG. 95. Once the robotic controller 11001determines that the surgical end effector 3212 is in the open positionby sensor(s) in the and effector and/or the tool mounting portion 3300,the robotic controller 11001 may provide the surgeon with a signal toinform the surgeon that the anvil 3224 may then be closed. Once thetarget tissue is positioned between the open anvil 3224 and the surgicalstaple cartridge 3234, the surgeon may then commence the closure processby activating the robotic controller 11001 to apply a closure controlsignal to the second closure motor 3360. The second closure motor 3360applies a rotary motion to the closure shaft 3340 to draw the channel3222 in the proximal direction “PD” until the anvil 3224 has beenpivoted to the closed position. Once the robotic controller 11001determines that the anvil 3224 has been moved to the closed position bysensor(s) in the surgical end effector 3212 and/or in the tool mountingportion 3300 that are in communication with the robotic control system,the motor 3360 may be deactivated. Thereafter, the firing process may becommenced either manually by the surgeon activating a trigger, button,etc. on the controller 11001 or the controller 11001 may automaticallycommence the firing process.

To commence the firing process, the robotic controller 11001 activatesthe firing motor 3310 to drive the firing bar 3235 and the cuttinginstrument 3232 in the distal direction “DD”. Once robotic controller11001 has determined that the cutting instrument 3232 has moved to theending position within the surgical staple cartridge 3234 by means ofsensors in the surgical end effector 3212 and/or the motor drive portion3300, the robotic controller 11001 may provide the surgeon with anindication signal. Thereafter the surgeon may manually activate thefirst motor 3310 to retract the cutting instrument 3232 to the startingposition or the robotic controller 11001 may automatically activate thefirst motor 3310 to retract the cutting element 3232.

The embodiment depicted in FIG. 95 does not include an articulationjoint. FIGS. 96 and 97 illustrate surgical tools 3200′ and 3200″ thathave end effectors 3212′, 3212″, respectively that may be employed withan elongated shaft embodiment that has an articulation joint of thevarious types disclosed herein. For example, as can be seen in FIG. 96,a threaded closure shaft 3342 is coupled to the proximal end 3223 of theelongated channel 3222 by a flexible cable or other flexible member3345. The location of an articulation joint (not shown) within theelongated shaft assembly 3208 will coincide with the flexible member3345 to enable the flexible member 3345 to accommodate sucharticulation. In addition, in the above-described embodiment, theflexible member 33345 is rotatably affixed to the proximal end portion3223 of the elongated channel 3222 to enable the flexible member 3345 torotate relative thereto to prevent the flexible member 3229 from“winding up” relative to the channel 3222. Although not shown, thecutting element may be driven in one of the above described manners by aknife bar that can also accommodate articulation of the elongated shaftassembly. FIG. 97 depicts a surgical end effector 3212″ that issubstantially identical to the surgical end effector 3212 describedabove, except that the threaded closure rod 3342 is attached to aclosure nut 3347 that is constrained to only move axially within theelongated shaft assembly 3208. The flexible member 3345 is attached tothe closure nut 3347. Such arrangement also prevents the threadedclosure rod 3342 from winding-up the flexible member 3345. A flexibleknife bar 3235′ may be employed to facilitate articulation of thesurgical end effector 3212″.

The surgical tools 3200, 3200′, and 3200″ described above may alsoemploy anyone of the cutting instrument embodiments described herein. Asdescribed above, the anvil of each of the end effectors of these toolsis closed by drawing the elongated channel into contact with the distalend of the elongated shaft assembly. Thus, once the target tissue hasbeen located between the staple cartridge 3234 and the anvil 3224, therobotic controller 11001 can start to draw the channel 3222 inward intothe shaft assembly 3208. In various embodiments, however, to prevent theend effector 3212, 3212′, 3212″ from moving the target tissue with theend effector during this closing process, the controller 11001 maysimultaneously move the tool holder and ultimately the tool such tocompensate for the movement of the elongated channel 3222 so that, ineffect, the target tissue is clamped between the anvil and the elongatedchannel without being otherwise moved.

FIGS. 98-100 depict another surgical tool embodiment 3201 that issubstantially identical to surgical tool 3200″ described above, exceptfor the differences discussed below. In this embodiment, the threadedclosure rod 3342′ has variable pitched grooves. More specifically, ascan be seen in FIG. 99, the closure rod 3342′ has a distal groovesection 3380 and a proximal groove section 3382. The distal and proximalgroove sections 3380, 3382 are configured for engagement with a lug 3390supported within the hollow threaded end portion 3341′. As can be seenin FIG. 99, the distal groove section 3380 has a finer pitch than thegroove section 3382. Thus, such variable pitch arrangement permits theelongated channel 3222 to be drawn into the shaft 3208 at a first speedor rate by virtue of the engagement between the lug 3390 and theproximal groove segment 3382. When the lug 3390 engages the distalgroove segment, the channel 3222 will be drawn into the shaft 3208 at asecond speed or rate. Because the proximal groove segment 3382 iscoarser than the distal groove segment 3380, the first speed will begreater than the second speed. Such arrangement serves to speed up theinitial closing of the end effector for tissue manipulation and thenafter the tissue has been properly positioned therein, generate theamount of closure forces to properly clamp the tissue for cutting andsealing. Thus, the anvil 3234 initially closes fast with a lower forceand then applies a higher closing force as the anvil closes more slowly.

The surgical end effector opening and closing motions are employed toenable the user to use the end effector to grasp and manipulate tissueprior to fully clamping it in the desired location for cutting andsealing. The user may, for example, open and close the surgical endeffector numerous times during this process to orient the end effectorin a proper position which enables the tissue to be held in a desiredlocation. Thus, in at least some embodiments, to produce the highloading for firing, the fine thread may require as many as 5-10 fullrotations to generate the necessary load. In some cases, for example,this action could take as long as 2-5 seconds. If it also took anequally long time to open and close the end effector each time duringthe positioning/tissue manipulation process, just positioning the endeffector may take an undesirably long time. If that happens, it ispossible that a user may abandon such use of the end effector for use ofa conventional grasper device. Use of graspers, etc. may undesirablyincrease the costs associated with completing the surgical procedure.

The above-described embodiments employ a battery or batteries to powerthe motors used to drive the end effector components. Activation of themotors is controlled by the robotic system 11000. In alternativeembodiments, the power supply may comprise alternating current “AC” thatis supplied to the motors by the robotic system 11000. That is, the ACpower would be supplied from the system powering the robotic system11000 through the tool holder and adapter. In still other embodiments, apower cord or tether may be attached to the tool mounting portion 3300to supply the requisite power from a separate source of alternating ordirect current.

In use, the controller 11001 may apply an initial rotary motion to theclosure shaft 3340 (FIG. 95) to draw the elongated channel 3222 axiallyinwardly into the elongated shaft assembly 3208 and move the anvil froma first position to an intermediate position at a first rate thatcorresponds with the point wherein the distal groove section 3380transitions to the proximal groove section 3382. Further application ofrotary motion to the closure shaft 3340 will cause the anvil to movefrom the intermediate position to the closed position relative to thesurgical staple cartridge. When in the closed position, the tissue to becut and stapled is properly clamped between the anvil and the surgicalstaple cartridge.

FIGS. 101-104 illustrate another surgical tool embodiment 3400 of thepresent invention. This embodiment includes an elongated shaft assembly3408 that extends from a tool mounting portion 3500. The elongated shaftassembly 3408 includes a rotatable proximal closure tube segment 3410that is rotatably journaled on a proximal spine member 3420 that isrigidly coupled to a tool mounting plate 3502 of the tool mountingportion 3500. The proximal spine member 3420 has a distal end 3422 thatis coupled to an elongated channel portion 3522 of a surgical endeffector 3412. For example, in at least one embodiment, the elongatedchannel portion 3522 has a distal end portion 3523 that “hookinglyengages” the distal end 3422 of the spine member 3420. The elongatedchannel 3522 is configured to support a surgical staple cartridge 3534therein. This embodiment may employ one of the various cuttinginstrument embodiments disclosed herein to sever tissue that is clampedin the surgical end effector 3412 and fire the staples in the staplecartridge 3534 into the severed tissue.

Surgical end effector 3412 has an anvil 3524 that is pivotally coupledto the elongated channel 3522 by a pair of trunnions 3525 that arereceived in corresponding openings 3529 in the elongated channel 3522.The anvil 3524 is moved between the open (FIG. 101) and closed positions(FIGS. 102-104) by a distal closure tube segment 3430. A distal endportion 3432 of the distal closure tube segment 3430 includes an opening3445 into which a tab 3527 on the anvil 3524 is inserted in order toopen and close the anvil 3524 as the distal closure tube segment 3430moves axially relative thereto. In various embodiments, the opening 3445is shaped such that as the closure tube segment 3430 is moved in theproximal direction, the closure tube segment 3430 causes the anvil 3524to pivot to an open position. In addition or in the alternative, aspring (not shown) may be employed to bias the anvil 3524 to the openposition.

As can be seen in FIGS. 101-104, the distal closure tube segment 3430includes a lug 3442 that extends from its distal end 3440 into threadedengagement with a variable pitch groove/thread 3414 formed in the distalend 3412 of the rotatable proximal closure tube segment 3410. Thevariable pitch groove/thread 3414 has a distal section 3416 and aproximal section 3418. The pitch of the distal groove/thread section3416 is finer than the pitch of the proximal groove/thread section 3418.As can also be seen in FIGS. 101-104, the distal closure tube segment3430 is constrained for axial movement relative to the spine member 3420by an axial retainer pin 3450 that is received in an axial slot 3424 inthe distal end of the spine member 3420.

As indicated above, the anvil 12524 is open and closed by rotating theproximal closure tube segment 3410. The variable pitch threadarrangement permits the distal closure tube segment 3430 to be driven inthe distal direction “DD” at a first speed or rate by virtue of theengagement between the lug 3442 and the proximal groove/thread section3418. When the lug 3442 engages the distal groove/thread section 3416,the distal closure tube segment 3430 will be driven in the distaldirection at a second speed or rate. Because the proximal groove/threadsection 3418 is coarser than the distal groove/thread segment 3416, thefirst speed will be greater than the second speed.

In at least one embodiment, the tool mounting portion 3500 is configuredto receive a corresponding first rotary motion from the roboticcontroller 11001 and convert that first rotary motion to a primaryrotary motion for rotating the rotatable proximal closure tube segment3410 about a longitudinal tool axis LT-LT. As can be seen in FIG. 105, aproximal end 3460 of the proximal closure tube segment 3410 is rotatablysupported within a cradle arrangement 3504 attached to a tool mountingplate 3502 of the tool mounting portion 3500. A rotation gear 3462 isformed on or attached to the proximal end 3460 of the closure tubesegment 3410 for meshing engagement with a rotation drive assembly 3470that is operably supported on the tool mounting plate 3502. In at leastone embodiment, a rotation drive gear 3472 is coupled to a correspondingfirst one of the driven discs or elements 11304 on the adapter side ofthe tool mounting plate 3502 when the tool mounting portion 3500 iscoupled to the tool holder 11270. See FIGS. 63 and 105. The rotationdrive assembly 3470 further comprises a rotary driven gear 3474 that isrotatably supported on the tool mounting plate 3502 in meshingengagement with the rotation gear 3462 and the rotation drive gear 3472.Application of a first rotary control motion from the robotic controller11001 through the tool holder 11270 and the adapter 11240 to thecorresponding driven element 11304 will thereby cause rotation of therotation drive gear 3472 by virtue of being operably coupled thereto.Rotation of the rotation drive gear 3472 ultimately results in therotation of the closure tube segment 3410 to open and close the anvil3524 as described above.

As indicated above, the surgical end effector 3412 employs a cuttinginstrument of the type and constructions described above. FIG. 105illustrates one form of knife drive assembly 3480 for axially advancinga knife bar 3492 that is attached to such cutting instrument. One formof the knife drive assembly 3480 comprises a rotary drive gear 3482 thatis coupled to a corresponding third one of the driven discs or elements11304 on the adapter side of the tool mounting plate 3502 when the tooldrive portion 3500 is coupled to the tool holder 11270. See FIGS. 63 and105. The knife drive assembly 3480 further comprises a first rotarydriven gear assembly 3484 that is rotatably supported on the toolmounting plate 5200. The first rotary driven gear assembly 3484 is inmeshing engagement with a third rotary driven gear assembly 3486 that isrotatably supported on the tool mounting plate 3502 and which is inmeshing engagement with a fourth rotary driven gear assembly 3488 thatis in meshing engagement with a threaded portion 3494 of drive shaftassembly 3490 that is coupled to the knife bar 3492. Rotation of therotary drive gear 3482 in a second rotary direction will result in theaxial advancement of the drive shaft assembly 3490 and knife bar 3492 inthe distal direction “DD”. Conversely, rotation of the rotary drive gear3482 in a secondary rotary direction (opposite to the second rotarydirection) will cause the drive shaft assembly 3490 and the knife bar3492 to move in the proximal direction.

FIGS. 106-115 illustrate another surgical tool 3600 embodiment of thepresent invention that may be employed in connection with a roboticsystem 11000. As can be seen in FIG. 106, the tool 3600 includes an endeffector in the form of a disposable loading unit 3612. Various forms ofdisposable loading units that may be employed in connection with tool3600 are disclosed, for example, in U.S. Patent Application PublicationNo. 2009/0206131, entitled END EFFECTOR ARRANGEMENTS FOR A SURGICALCUTTING AND STAPLING INSTRUMENT, the disclosure of which is hereinincorporated by reference in its entirety.

In at least one form, the disposable loading unit 3612 includes an anvilassembly 3620 that is supported for pivotal travel relative to a carrier3630 that operably supports a staple cartridge 3640 therein. A mountingassembly 3650 is pivotally coupled to the cartridge carrier 3630 toenable the carrier 3630 to pivot about an articulation axis AA-AArelative to a longitudinal tool axis LT-LT. Referring to FIG. 111,mounting assembly 3650 includes upper and lower mounting portions 3652and 3654. Each mounting portion includes a threaded bore 3656 on eachside thereof dimensioned to receive threaded bolts (not shown) forsecuring the proximal end of carrier 3630 thereto. A pair of centrallylocated pivot members 3658 extends between upper and lower mountingportions via a pair of coupling members 3660 which engage a distal endof a housing portion 3662. Coupling members 3660 each include aninterlocking proximal portion 3664 configured to be received in grooves3666 formed in the proximal end of housing portion 3662 to retainmounting assembly 3650 and housing portion 3662 in a longitudinallyfixed position in relation thereto.

In various forms, housing portion 3662 of disposable loading unit 3614includes an upper housing half 3670 and a lower housing half 3672contained within an outer casing 3674. The proximal end of housing half3670 includes engagement nubs 3676 for releasably engaging an elongatedshaft 3700 and an insertion tip 3678. Nubs 3676 form a bayonet-typecoupling with the distal end of the elongated shaft 3700 which will bediscussed in further detail below. Housing halves 3670, 3672 define achannel 3674 for slidably receiving axial drive assembly 3680. A secondarticulation link 3690 is dimensioned to be slidably positioned within aslot 3679 formed between housing halves 3670, 3672. A pair of blow outplates 3691 are positioned adjacent the distal end of housing portion3662 adjacent the distal end of axial drive assembly 3680 to preventoutward bulging of drive assembly 3680 during articulation of carrier3630.

In various embodiments, the second articulation link 3690 includes atleast one elongated metallic plate. Preferably, two or more metallicplates are stacked to form link 3690. The proximal end of articulationlink 3690 includes a hook portion 3692 configured to engage firstarticulation link 3710 extending through the elongated shaft 3700. Thedistal end of the second articulation link 3690 includes a loop 3694dimensioned to engage a projection formed on mounting assembly 3650. Theprojection is laterally offset from pivot pin 3658 such that linearmovement of second articulation link 3690 causes mounting assembly 3650to pivot about pivot pins 3658 to articulate the carrier 3630.

In various forms, axial drive assembly 3680 includes an elongated drivebeam 3682 including a distal working head 3684 and a proximal engagementsection 3685. Drive beam 3682 may be constructed from a single sheet ofmaterial or, preferably, multiple stacked sheets. Engagement section3685 includes a pair of engagement fingers which are dimensioned andconfigured to mountingly engage a pair of corresponding retention slotsformed in drive member 3686. Drive member 3686 includes a proximalporthole 3687 configured to receive the distal end 3722 of control rod12720 (See FIG. 115) when the proximal end of disposable loading unit3614 is engaged with elongated shaft 3700 of surgical tool 3600.

Referring to FIGS. 106 and 113-115, to use the surgical tool 3600, adisposable loading unit 3612 is first secured to the distal end ofelongated shaft 3700. It will be appreciated that the surgical tool 3600may include an articulating or a non-articulating disposable loadingunit. To secure the disposable loading unit 3612 to the elongated shaft3700, the distal end 3722 of control rod 3720 is inserted into insertiontip 3678 of disposable loading unit 3612, and insertion tip 3678 is slidlongitudinally into the distal end of the elongated shaft 3700 in thedirection indicated by arrow “A” in FIG. 113 such that hook portion 3692of second articulation link 3690 slides within a channel 3702 in theelongated shaft 3700. Nubs 3676 will each be aligned in a respectivechannel (not shown) in elongated shaft 3700. When hook portion 3692engages the proximal wall 3704 of channel 3702, disposable loading unit3612 is rotated in the direction indicated by arrow “B” in FIGS. 112 and113 to move hook portion 3692 of second articulation link 3690 intoengagement with finger 3712 of first articulation link 3710. Nubs 3676also form a “bayonet-type” coupling within annular channel 3703 in theelongated shaft 3700. During rotation of loading unit 3612, nubs 3676engage cam surface 3732 (FIG. 113) of block plate 3730 to initially moveplate 3730 in the direction indicated by arrow “C” in FIG. 113 to lockengagement member 3734 in recess 3721 of control rod 3720 to preventlongitudinal movement of control rod 3720 during attachment ofdisposable loading unit 3612. During the final degree of rotation, nubs3676 disengage from cam surface 3732 to allow blocking plate 3730 tomove in the direction indicated by arrow “D” in FIGS. 112 and 115 frombehind engagement member 3734 to once again permit longitudinal movementof control rod 3720. While the above-described attachment methodreflects that the disposable loading unit 3612 is manipulated relativeto the elongated shaft 3700, the person of ordinary skill in the artwill appreciate that the disposable loading unit 3612 may be supportedin a stationary position and the robotic system 11000 may manipulate theelongated shaft portion 3700 relative to the disposable loading unit3612 to accomplish the above-described coupling procedure.

FIG. 116 illustrates another disposable loading unit 3612′ that isattachable in a bayonet-type arrangement with the elongated shaft 3700′that is substantially identical to shaft 3700 except for the differencesdiscussed below. As can be seen in FIG. 116, the elongated shaft 3700′has slots 3705 that extend for at least a portion thereof and which areconfigured to receive nubs 3676 therein. In various embodiments, thedisposable loading unit 3612′ includes arms 3677 extending therefromwhich, prior to the rotation of disposable loading unit 3612′, can bealigned, or at least substantially aligned, with nubs 3676 extendingfrom housing portion 3662. In at least one embodiment, arms 3677 andnubs 3676 can be inserted into slots 3705 in elongated shaft 3700′, forexample, when disposable loading unit 3612′ is inserted into elongatedshaft 3700′. When disposable loading unit 3612′ is rotated, arms 3677can be sufficiently confined within slots 3705 such that slots 3705 canhold them in position, whereas nubs 3676 can be positioned such thatthey are not confined within slots 3705 and can be rotated relative toarms 3677. When rotated, the hook portion 3692 of the articulation link3690 is engaged with the first articulation link 3710 extending throughthe elongated shaft 3700′.

Other methods of coupling the disposable loading units to the end of theelongated shaft may be employed. For example, as shown in FIGS. 117 and118, disposable loading unit 3612″ can include connector portion 3613which can be configured to be engaged with connector portion 3740 of theelongated shaft 3700″. In at least one embodiment, connector portion3613 can include at least one projection and/or groove which can bemated with at least one projection and/or groove of connector portion3740. In at least one such embodiment, the connector portions caninclude co-operating dovetail portions. In various embodiments, theconnector portions can be configured to interlock with one another andprevent, or at least inhibit, distal and/or proximal movement ofdisposable loading unit 3612″ along axis 3741. In at least oneembodiment, the distal end of the axial drive assembly 3680′ can includeaperture 3681 which can be configured to receive projection 3721extending from control rod 3720′. In various embodiments, such anarrangement can allow disposable loading unit 3612″ to be assembled toelongated shaft 3700 in a direction which is not collinear with orparallel to axis 3741. Although not illustrated, axial drive assembly3680′ and control rod 3720 can include any other suitable arrangement ofprojections and apertures to operably connect them to each other. Alsoin this embodiment, the first articulation link 3710 which can beoperably engaged with second articulation link 3690.

As can be seen in FIGS. 106 and 119, the surgical tool 3600 includes atool mounting portion 3750. The tool mounting portion 3750 includes atool mounting plate 3751 that is configured for attachment to the tooldrive assembly 11010. The tool mounting portion operably supported atransmission arrangement 3752 thereon. In use, it may be desirable torotate the disposable loading unit 3612 about the longitudinal tool axisdefined by the elongated shaft 3700. In at least one embodiment, thetransmission arrangement 3752 includes a rotational transmissionassembly 3753 that is configured to receive a corresponding rotaryoutput motion from the tool drive assembly 11010 of the robotic system11000 and convert that rotary output motion to a rotary control motionfor rotating the elongated shaft 3700 (and the disposable loading unit3612) about the longitudinal tool axis LT-LT. As can be seen in FIG.119, a proximal end 3701 of the elongated shaft 3700 is rotatablysupported within a cradle arrangement 3754 that is attached to the toolmounting plate 3751 of the tool mounting portion 3750. A rotation gear3755 is formed on or attached to the proximal end 3701 of the elongatedshaft 3700 for meshing engagement with a rotation gear assembly 3756operably supported on the tool mounting plate 3751. In at least oneembodiment, a rotation drive gear 3757 drivingly coupled to acorresponding first one of the driven discs or elements 11304 on theadapter side of the tool mounting plate 3751 when the tool mountingportion 3750 is coupled to the tool drive assembly 11010. The rotationtransmission assembly 3753 further comprises a rotary driven gear 3758that is rotatably supported on the tool mounting plate 3751 in meshingengagement with the rotation gear 3755 and the rotation drive gear 3757.Application of a first rotary output motion from the robotic system11000 through the tool drive assembly 11010 to the corresponding drivenelement 11304 will thereby cause rotation of the rotation drive gear3757 by virtue of being operably coupled thereto. Rotation of therotation drive gear 3757 ultimately results in the rotation of theelongated shaft 3700 (and the disposable loading unit 3612) about thelongitudinal tool axis LT-LT (primary rotary motion).

As can be seen in FIG. 119, a drive shaft assembly 3760 is coupled to aproximal end of the control rod 12720. In various embodiments, thecontrol rod 12720 is axially advanced in the distal and proximaldirections by a knife/closure drive transmission 3762. One form of theknife/closure drive assembly 3762 comprises a rotary drive gear 3763that is coupled to a corresponding second one of the driven rotatablebody portions, discs or elements 11304 on the adapter side of the toolmounting plate 3751 when the tool mounting portion 3750 is coupled tothe tool holder 11270. The rotary driven gear 3763 is in meshing drivingengagement with a gear train, generally depicted as 3764. In at leastone form, the gear train 3764 further comprises a first rotary drivengear assembly 3765 that is rotatably supported on the tool mountingplate 3751. The first rotary driven gear assembly 3765 is in meshingengagement with a second rotary driven gear assembly 3766 that isrotatably supported on the tool mounting plate 3751 and which is inmeshing engagement with a third rotary driven gear assembly 3767 that isin meshing engagement with a threaded portion 3768 of the drive shaftassembly 3760. Rotation of the rotary drive gear 3763 in a second rotarydirection will result in the axial advancement of the drive shaftassembly 3760 and control rod 12720 in the distal direction “DD”.Conversely, rotation of the rotary drive gear 3763 in a secondary rotarydirection which is opposite to the second rotary direction will causethe drive shaft assembly 3760 and the control rod 12720 to move in theproximal direction. When the control rod 12720 moves in the distaldirection, it drives the drive beam 3682 and the working head 3684thereof distally through the surgical staple cartridge 3640. As theworking head 3684 is driven distally, it operably engages the anvil 3620to pivot it to a closed position.

The cartridge carrier 3630 may be selectively articulated aboutarticulation axis AA-AA by applying axial articulation control motionsto the first and second articulation links 3710 and 3690. In variousembodiments, the transmission arrangement 3752 further includes anarticulation drive 3770 that is operably supported on the tool mountingplate 3751. More specifically and with reference to FIG. 119, it can beseen that a proximal end portion 3772 of an articulation drive shaft3771 configured to operably engage with the first articulation link 3710extends through the rotation gear 3755 and is rotatably coupled to ashifter rack gear 3774 that is slidably affixed to the tool mountingplate 3751 through slots 3775. The articulation drive 3770 furthercomprises a shifter drive gear 3776 that is coupled to a correspondingthird one of the driven discs or elements 11304 on the adapter side ofthe tool mounting plate 3751 when the tool mounting portion 3750 iscoupled to the tool holder 11270. The articulation drive assembly 3770further comprises a shifter driven gear 3778 that is rotatably supportedon the tool mounting plate 3751 in meshing engagement with the shifterdrive gear 3776 and the shifter rack gear 3774. Application of a thirdrotary output motion from the robotic system 11000 through the tooldrive assembly 11010 to the corresponding driven element 11304 willthereby cause rotation of the shifter drive gear 3776 by virtue of beingoperably coupled thereto. Rotation of the shifter drive gear 3776ultimately results in the axial movement of the shifter gear rack 3774and the articulation drive shaft 3771. The direction of axial travel ofthe articulation drive shaft 3771 depends upon the direction in whichthe shifter drive gear 3776 is rotated by the robotic system 11000.Thus, rotation of the shifter drive gear 3776 in a first rotarydirection will result in the axial movement of the articulation driveshaft 3771 in the proximal direction “PD” and cause the cartridgecarrier 3630 to pivot in a first direction about articulation axisAA-AA. Conversely, rotation of the shifter drive gear 3776 in a secondrotary direction (opposite to the first rotary direction) will result inthe axial movement of the articulation drive shaft 3771 in the distaldirection “DD” to thereby cause the cartridge carrier 3630 to pivotabout articulation axis AA-AA in an opposite direction.

FIG. 120 illustrates yet another surgical tool 3800 embodiment of thepresent invention that may be employed with a robotic system 11000. Ascan be seen in FIG. 120, the surgical tool 3800 includes a surgical endeffector 3812 in the form of an endocutter 3814 that employs variouscable-driven components. Various forms of cable driven endocutters aredisclosed, for example, in U.S. Pat. No. 7,726,537, entitled SURGICALSTAPLER WITH UNIVERSAL ARTICULATION AND TISSUE PRE-CLAMP and U.S. PatentApplication Publication No. 2008/0308603, entitled CABLE DRIVEN SURGICALSTAPLING AND CUTTING INSTRUMENT WITH IMPROVED CABLE ATTACHMENTARRANGEMENTS, the disclosures of each are herein incorporated byreference in their respective entireties. Such endocutters 3814 may bereferred to as a “disposable loading unit” because they are designed tobe disposed of after a single use. However, the various unique and novelarrangements of various embodiments of the present invention may also beemployed in connection with cable driven end effectors that arereusable.

As can be seen in FIG. 121, in at least one form, the endocutter 3814includes an elongated channel 3822 that operably supports a surgicalstaple cartridge 3834 therein. An anvil 3824 is pivotally supported formovement relative to the surgical staple cartridge 3834. The anvil 3824has a cam surface 3825 that is configured for interaction with apreclamping collar 3840 that is supported for axial movement relativethereto. The end effector 3814 is coupled to an elongated shaft assembly3808 that is attached to a tool mounting portion 3900. In variousembodiments, a closure cable 3850 is employed to move pre-clampingcollar 3840 distally onto and over cam surface 3825 to close the anvil3824 relative to the surgical staple cartridge 3834 and compress thetissue therebetween. Preferably, closure cable 3850 attaches to thepre-clamping collar 3840 at or near point 3841 and is fed through apassageway in anvil 3824 (or under a proximal portion of anvil 3824) andfed proximally through shaft 3808. Actuation of closure cable 3850 inthe proximal direction “PD” forces pre-clamping collar 3840 distallyagainst cam surface 3825 to close anvil 3824 relative to staplecartridge assembly 3834. A return mechanism, e.g., a spring, cablesystem or the like, may be employed to return pre-clamping collar 3840to a pre-clamping orientation which re-opens the anvil 3824.

The elongated shaft assembly 3808 may be cylindrical in shape and definea channel 3811 which may be dimensioned to receive a tube adapter 3870.See FIG. 121. In various embodiments, the tube adapter 3870 may beslidingly received in friction-fit engagement with the internal channelof elongated shaft 3808. The outer surface of the tube adapter 3870 mayfurther include at least one mechanical interface, e.g., a cutout ornotch 3871, oriented to mate with a corresponding mechanical interface,e.g., a radially inwardly extending protrusion or detent (not shown),disposed on the inner periphery of internal channel 3811 to lock thetube adapter 3870 to the elongated shaft 3808. In various embodiments,the distal end of tube adapter 3870 may include a pair of opposingflanges 3872 a and 3872 b which define a cavity for pivotably receivinga pivot block 3873 therein. Each flange 3872 a and 3872 b may include anaperture 3874 a and 3874 b that is oriented to receive a pivot pin 3875that extends through an aperture in pivot block 3873 to allow pivotablemovement of pivot block 3873 about an axis that is perpendicular tolongitudinal tool axis “LT-LT”. The channel 3822 may be formed with twoupwardly extending flanges 3823 a, 3823 b that have apertures therein,which are dimensioned to receive a pivot pin 3827. In turn, pivot pin3875 mounts through apertures in pivot block 3873 to permit rotation ofthe surgical end effector 3814 about the “Y” axis as needed during agiven surgical procedure. Rotation of pivot block 3873 about pin 3875along “Z” axis rotates the surgical end effector 3814 about the “Z”axis. See FIG. 121. Other methods of fastening the elongated channel3822 to the pivot block 3873 may be effectively employed withoutdeparting from the spirit and scope of the present invention.

The surgical staple cartridge 3834 can be assembled and mounted withinthe elongated channel 3822 during the manufacturing or assembly processand sold as part of the surgical end effector 3812, or the surgicalstaple cartridge 3834 may be designed for selective mounting within theelongated channel 3822 as needed and sold separately, e.g., as a singleuse replacement, replaceable or disposable staple cartridge assembly. Itis within the scope of this disclosure that the surgical end effector3812 may be pivotally, operatively, or integrally attached, for example,to distal end 3809 of the elongated shaft assembly 3808 of a disposablesurgical stapler. As is known, a used or spent disposable loading unit3814 can be removed from the elongated shaft assembly 3808 and replacedwith an unused disposable unit. The endocutter 3814 may also preferablyinclude an actuator, preferably a dynamic clamping member 3860, a sled3862, as well as staple pushers (not shown) and staples (not shown) oncean unspent or unused cartridge 3834 is mounted in the elongated channel3822. See FIG. 121.

In various embodiments, the dynamic clamping member 3860 is associatedwith, e.g., mounted on and rides on, or with or is connected to orintegral with and/or rides behind sled 3862. It is envisioned thatdynamic clamping member 3860 can have cam wedges or cam surfacesattached or integrally formed or be pushed by a leading distal surfacethereof. In various embodiments, dynamic clamping member 3860 mayinclude an upper portion 3863 having a transverse aperture 3864 with apin 3865 mountable or mounted therein, a central support or upwardextension 3866 and substantially T-shaped bottom flange 3867 whichcooperate to slidingly retain dynamic clamping member 3860 along anideal cutting path during longitudinal, distal movement of sled 3862.The leading cutting edge 3868, here, knife blade 3869, is dimensioned toride within slot 3835 of staple cartridge assembly 3834 and separatetissue once stapled. As used herein, the term “knife assembly” mayinclude the aforementioned dynamic clamping member 3860, knife 3869, andsled 3862 or other knife/beam/sled drive arrangements and cuttinginstrument arrangements. In addition, the various embodiments of thepresent invention may be employed with knife assembly/cutting instrumentarrangements that may be entirely supported in the staple cartridge 3834or partially supported in the staple cartridge 3834 and elongatedchannel 3822 or entirely supported within the elongated channel 3822.

In various embodiments, the dynamic clamping member 3860 may be drivenin the proximal and distal directions by a cable drive assembly 3870. Inone non-limiting form, the cable drive assembly comprises a pair ofadvance cables 3880, 3882 and a firing cable 3884. FIGS. 122 and 123illustrate the cables 3880, 3882, 3884 in diagrammatic form. As can beseen in those FIGS., a first advance cable 3880 is operably supported ona first distal cable transition support 3885 which may comprise, forexample, a pulley, rod, capstan, etc. that is attached to the distal endof the elongated channel 3822 and a first proximal cable transitionsupport 3886 which may comprise, for example, a pulley, rod, capstan,etc. that is operably supported by the elongated channel 3822. A distalend 3881 of the first advance cable 3880 is affixed to the dynamicclamping assembly 3860. The second advance cable 3882 is operablysupported on a second distal cable transition support 3887 which may,for example, comprise a pulley, rod, capstan etc. that is mounted to thedistal end of the elongated channel 3822 and a second proximal cabletransition support 3888 which may, for example, comprise a pulley, rod,capstan, etc. mounted to the proximal end of the elongated channel 3822.The proximal end 3883 of the second advance cable 3882 may be attachedto the dynamic clamping assembly 3860. Also in these embodiments, anendless firing cable 3884 is employed and journaled on a support 3889that may comprise a pulley, rod, capstan, etc. mounted within theelongated shaft 3808. In one embodiment, the retract cable 3884 may beformed in a loop and coupled to a connector 3889′ that is fixedlyattached to the first and second advance cables 3880, 3882.

Various non-limiting embodiments of the present invention include acable drive transmission 3920 that is operably supported on a toolmounting plate 3902 of the tool mounting portion 3900. The tool mountingportion 3900 has an array of electrical connecting pins 3904 which areconfigured to interface with the slots 11258 (FIG. 62) in the adapter11240′. Such arrangement permits the robotic system 11000 to providecontrol signals to a control circuit 3910 of the tool 3800. While theinterface is described herein with reference to mechanical, electrical,and magnetic coupling elements, it should be understood that a widevariety of telemetry modalities might be used, including infrared,inductive coupling, or the like.

Control circuit 3910 is shown in schematic form in FIG. 120. In one formor embodiment, the control circuit 3910 includes a power supply in theform of a battery 3912 that is coupled to an on-off solenoid poweredswitch 3914. In other embodiments, however, the power supply maycomprise a source of alternating current. Control circuit 3910 furtherincludes an on/off solenoid 3916 that is coupled to a double pole switch3918 for controlling motor rotation direction. Thus, when the roboticsystem 11000 supplies an appropriate control signal, switch 3914 willpermit battery 3912 to supply power to the double pole switch 3918. Therobotic system 11000 will also supply an appropriate signal to thedouble pole switch 3918 to supply power to a shifter motor 3922.

Turning to FIGS. 124-129, at least one embodiment of the cable drivetransmission 3920 comprises a drive pulley 3930 that is operably mountedto a drive shaft 3932 that is attached to a driven element 11304 of thetype and construction described above that is designed to interface witha corresponding drive element 11250 of the adapter 11240. See FIGS. 62and 127. Thus, when the tool mounting portion 3900 is operably coupledto the tool holder 11270, the robot system 11000 can apply rotary motionto the drive pulley 3930 in a desired direction. A first drive member orbelt 3934 drivingly engages the drive pulley 3930 and a second driveshaft 3936 that is rotatably supported on a shifter yoke 3940. Theshifter yoke 3940 is operably coupled to the shifter motor 3922 suchthat rotation of the shaft 3923 of the shifter motor 3922 in a firstdirection will shift the shifter yoke in a first direction “FD” androtation of the shifter motor shaft 3923 in a second direction willshift the shifter yoke 3940 in a second direction “SD”. Otherembodiments of the present invention may employ a shifter solenoidarrangement for shifting the shifter yoke in said first and seconddirections.

As can be seen in FIGS. 124-127, a closure drive gear 3950 mounted to asecond drive shaft 3936 and is configured to selectively mesh with aclosure drive assembly, generally designated as 3951. Likewise a firingdrive gear 3960 is also mounted to the second drive shaft 3936 and isconfigured to selectively mesh with a firing drive assembly generallydesignated as 3961. Rotation of the second drive shaft 3936 causes theclosure drive gear 3950 and the firing drive gear 3960 to rotate. In onenon-limiting embodiment, the closure drive assembly 3951 comprises aclosure driven gear 3952 that is coupled to a first closure pulley 3954that is rotatably supported on a third drive shaft 3956. The closurecable 3850 is drivingly received on the first closure pulley 3954 suchthat rotation of the closure driven gear 3952 will drive the closurecable 3850. Likewise, the firing drive assembly 3961 comprises a firingdriven gear 3962 that is coupled to a first firing pulley 3964 that isrotatably supported on the third drive shaft 3956. The first and seconddriving pulleys 3954 and 3964 are independently rotatable on the thirddrive shaft 3956. The firing cable 3884 is drivingly received on thefirst firing pulley 3964 such that rotation of the firing driven gear3962 will drive the firing cable 3884.

Also in various embodiments, the cable drive transmission 3920 furtherincludes a braking assembly 3970. In at least one embodiment, forexample, the braking assembly 3970 includes a closure brake 3972 thatcomprises a spring arm 3973 that is attached to a portion of thetransmission housing 3971. The closure brake 3972 has a gear lug 3974that is sized to engage the teeth of the closure driven gear 3952 aswill be discussed in further detail below. The braking assembly 3970further includes a firing brake 3976 that comprises a spring arm 3977that is attached to another portion of the transmission housing 3971.The firing brake 3976 has a gear lug 3978 that is sized to engage theteeth of the firing driven gear 3962.

At least one embodiment of the surgical tool 3800 may be used asfollows. The tool mounting portion 3900 is operably coupled to theinterface 11240 of the robotic system 11000. The controller or controlunit of the robotic system is operated to locate the tissue to be cutand stapled between the open anvil 3824 and the staple cartridge 3834.When in that initial position, the braking assembly 3970 has locked theclosure driven gear 3952 and the firing driven gear 3962 such that theycannot rotate. That is, as shown in FIG. 125, the gear lug 3974 is inlocking engagement with the closure driven gear 3952 and the gear lug3978 is in locking engagement with the firing driven gear 3962. Once thesurgical end effector 3814 has been properly located, the controller11001 of the robotic system 11000 will provide a control signal to theshifter motor 3922 (or shifter solenoid) to move the shifter yoke 3940in the first direction. As the shifter yoke 3940 is moved in the firstdirection, the closure drive gear 3950 moves the gear lug 3974 out ofengagement with the closure driven gear 3952 as it moves into meshingengagement with the closure driven gear 3952. As can be seen in FIG.124, when in that position, the gear lug 3978 remains in lockingengagement with the firing driven gear 3962 to prevent actuation of thefiring system. Thereafter, the robotic controller 11001 provides a firstrotary actuation motion to the drive pulley 3930 through the interfacebetween the driven element 11304 and the corresponding components of thetool holder 11240. As the drive pulley 3930 is rotated in the firstdirection, the closure cable 3850 is rotated to drive the preclampingcollar 3840 into closing engagement with the cam surface 3825 of theanvil 3824 to move it to the closed position thereby clamping the targettissue between the anvil 3824 and the staple cartridge 3834. See FIG.120. Once the anvil 3824 has been moved to the closed position, therobotic controller 11001 stops the application of the first rotarymotion to the drive pulley 3930. Thereafter, the robotic controller11001 may commence the firing process by sending another control signalto the shifter motor 3922 (or shifter solenoid) to cause the shifteryoke to move in the second direction “SD” as shown in FIG. 126. As theshifter yoke 3940 is moved in the second direction, the firing drivegear 3960 moves the gear lug 3978 out of engagement with the firingdriven gear 3962 as it moves into meshing engagement with the firingdriven gear 3962. As can be seen in FIG. 126, when in that position, thegear lug 3974 remains in locking engagement with the closure driven gear3952 to prevent actuation of the closure system. Thereafter, the roboticcontroller 11001 is activated to provide the first rotary actuationmotion to the drive pulley 3930 through the interface between the drivenelement 11304 and the corresponding components of the tool holder 11240.As the drive pulley 3930 is rotated in the first direction, the firingcable 3884 is rotated to drive the dynamic clamping member 3860 in thedistal direction “DD” thereby firing the stapes and cutting the tissueclamped in the end effector 3814. Once the robotic system 11000determines that the dynamic clamping member 3860 has reached its distalmost position—either through sensors or through monitoring the amount ofrotary input applied to the drive pulley 3930, the controller 11001 maythen apply a second rotary motion to the drive pulley 3930 to rotate theclosure cable 3850 in an opposite direction to cause the dynamicclamping member 3860 to be retracted in the proximal direction “PD”.Once the dynamic clamping member has been retracted to the startingposition, the application of the second rotary motion to the drivepulley 3930 is discontinued. Thereafter, the shifter motor 3922 (orshifter solenoid) is powered to move the shifter yoke 3940 to theclosure position (FIG. 92.). Once the closure drive gear 3950 is inmeshing engagement with the closure driven gear 3952, the roboticcontroller 11001 may once again apply the second rotary motion to thedrive pulley 3930. Rotation of the drive pulley 3930 in the seconddirection causes the closure cable 3850 to retract the preclampingcollar 3840 out of engagement with the cam surface 3825 of the anvil3824 to permit the anvil 3824 to move to an open position (by a springor other means) to release the stapled tissue from the surgical endeffector 3814.

FIG. 130 illustrates a surgical tool 4000 that employs a gear drivenfiring bar 4092 as shown in FIGS. 131-133. This embodiment includes anelongated shaft assembly 4008 that extends from a tool mounting portion4100. The tool mounting portion 4100 includes a tool mounting plate 4102that operable supports a transmission arrangement 4103 thereon. Theelongated shaft assembly 4008 includes a rotatable proximal closure tube4010 that is rotatably journaled on a proximal spine member 4020 that isrigidly coupled to the tool mounting plate 4102. The proximal spinemember 4020 has a distal end that is coupled to an elongated channelportion 4022 of a surgical end effector 4012. The surgical effector 4012may be substantially similar to surgical end effector 3412 describedabove. In addition, the anvil 4024 of the surgical end effector 4012 maybe opened and closed by a distal closure tube 4030 that operablyinterfaces with the proximal closure tube 4010. Distal closure tube 4030is identical to distal closure tube 3430 described above. Similarly,proximal closure tube 4010 is identical to proximal closure tube segment3410 described above.

Anvil 4024 is opened and closed by rotating the proximal closure tube4010 in manner described above with respect to distal closure tube 3410.In at least one embodiment, the transmission arrangement comprises aclosure transmission, generally designated as 4011. As will be furtherdiscussed below, the closure transmission 4011 is configured to receivea corresponding first rotary motion from the robotic system 11000 andconvert that first rotary motion to a primary rotary motion for rotatingthe rotatable proximal closure tube 4010 about the longitudinal toolaxis LT-LT. As can be seen in FIG. 133, a proximal end 4060 of theproximal closure tube 4010 is rotatably supported within a cradlearrangement 4104 that is attached to a tool mounting plate 4102 of thetool mounting portion 4100. A rotation gear 4062 is formed on orattached to the proximal end 4060 of the closure tube segment 4010 formeshing engagement with a rotation drive assembly 4070 that is operablysupported on the tool mounting plate 4102. In at least one embodiment, arotation drive gear 4072 is coupled to a corresponding first one of thedriven discs or elements 11304 on the adapter side of the tool mountingplate 4102 when the tool mounting portion 4100 is coupled to the toolholder 11270. See FIGS. 63 and 133. The rotation drive assembly 4070further comprises a rotary driven gear 4074 that is rotatably supportedon the tool mounting plate 4102 in meshing engagement with the rotationgear 4062 and the rotation drive gear 4072. Application of a firstrotary control motion from the robotic system 11000 through the toolholder 11270 and the adapter 11240 to the corresponding driven element11304 will thereby cause rotation of the rotation drive gear 4072 byvirtue of being operably coupled thereto. Rotation of the rotation drivegear 4072 ultimately results in the rotation of the closure tube segment4010 to open and close the anvil 4024 as described above.

As indicated above, the end effector 4012 employs a cutting element 3860as shown in FIGS. 131 and 132. In at least one non-limiting embodiment,the transmission arrangement 4103 further comprises a knife drivetransmission that includes a knife drive assembly 4080. FIG. 133illustrates one form of knife drive assembly 4080 for axially advancingthe knife bar 4092 that is attached to such cutting element using cablesas described above with respect to surgical tool 3800. In particular,the knife bar 4092 replaces the firing cable 3884 employed in anembodiment of surgical tool 3800. One form of the knife drive assembly4080 comprises a rotary drive gear 4082 that is coupled to acorresponding second one of the driven discs or elements 11304 on theadapter side of the tool mounting plate 4102 when the tool mountingportion 4100 is coupled to the tool holder 11270. See FIGS. 63 and 133.The knife drive assembly 4080 further comprises a first rotary drivengear assembly 4084 that is rotatably supported on the tool mountingplate 4102. The first rotary driven gear assembly 4084 is in meshingengagement with a third rotary driven gear assembly 4086 that isrotatably supported on the tool mounting plate 4102 and which is inmeshing engagement with a fourth rotary driven gear assembly 4088 thatis in meshing engagement with a threaded portion 4094 of drive shaftassembly 4090 that is coupled to the knife bar 4092. Rotation of therotary drive gear 4082 in a second rotary direction will result in theaxial advancement of the drive shaft assembly 4090 and knife bar 4092 inthe distal direction “DD”. Conversely, rotation of the rotary drive gear4082 in a secondary rotary direction (opposite to the second rotarydirection) will cause the drive shaft assembly 4090 and the knife bar4092 to move in the proximal direction. Movement of the firing bar 4092in the proximal direction “PD” will drive the cutting element 3860 inthe distal direction “DD”. Conversely, movement of the firing bar 4092in the distal direction “DD” will result in the movement of the cuttingelement 3860 in the proximal direction “PD”.

FIGS. 134-140 illustrate yet another surgical tool 5000 that may beeffectively employed in connection with a robotic system 11000. Invarious forms, the surgical tool 5000 includes a surgical end effector5012 in the form of a surgical stapling instrument that includes anelongated channel 5020 and a pivotally translatable clamping member,such as an anvil 5070, which are maintained at a spacing that assureseffective stapling and severing of tissue clamped in the surgical endeffector 5012. As can be seen in FIG. 136, the elongated channel 5020may be substantially U-shaped in cross-section and be fabricated from,for example, titanium, 203 stainless steel, 304 stainless steel, 416stainless steel, 17-4 stainless steel, 17-7 stainless steel, 6061 or7075 aluminum, chromium steel, ceramic, etc. A substantially U-shapedmetal channel pan 5022 may be supported in the bottom of the elongatedchannel 5020 as shown.

Various embodiments include an actuation member in the form of a sledassembly 5030 that is operably supported within the surgical endeffector 5012 and axially movable therein between a starting positionand an ending position in response to control motions applied thereto.In some forms, the metal channel pan 5022 has a centrally-disposed slot5024 therein to movably accommodate a base portion 5032 of the sledassembly 5030. The base portion 5032 includes a foot portion 5034 thatis sized to be slidably received in a slot 5021 in the elongated channel5020. See FIG. 136. As can be seen in FIGS. 135, 136, 139, and 140, thebase portion 5032 of sled assembly 5030 includes an axially extendingthreaded bore 5036 that is configured to be threadedly received on athreaded drive shaft 5130 as will be discussed in further detail below.In addition, the sled assembly 5030 includes an upstanding supportportion 5038 that supports a tissue cutting blade or tissue cuttinginstrument 5040. The upstanding support portion 5038 terminates in a topportion 5042 that has a pair of laterally extending retaining fins 5044protruding therefrom. As shown in FIG. 136, the fins 5044 are positionedto be received within corresponding slots 5072 in anvil 5070. The fins5044 and the foot 5034 serve to retain the anvil 5070 in a desiredspaced closed position as the sled assembly 5030 is driven distallythrough the tissue clamped within the surgical end effector 5014. As canalso be seen in FIGS. 138 and 140, the sled assembly 5030 furtherincludes a reciprocatably or sequentially activatable drive assembly5050 for driving staple pushers toward the closed anvil 5070.

More specifically and with reference to FIGS. 136 and 137, the elongatedchannel 5020 is configured to operably support a surgical staplecartridge 5080 therein. In at least one form, the surgical staplecartridge 5080 comprises a body portion 5082 that may be fabricatedfrom, for example, Vectra, Nylon (6/6 or 6/12) and include a centrallydisposed slot 5084 for accommodating the upstanding support portion 5038of the sled assembly 5030. See FIG. 136. These materials could also befilled with glass, carbon, or mineral fill of 10%-40%. The surgicalstaple cartridge 5080 further includes a plurality of cavities 5086 formovably supporting lines or rows of staple-supporting pushers 5088therein. The cavities 5086 may be arranged in spaced longitudinallyextending lines or rows 5090, 5092, 5094, 5096. For example, the rows5090 may be referred to herein as first outboard rows. The rows 5092 maybe referred to herein as first inboard rows. The rows 5094 may bereferred to as second inboard rows and the rows 5096 may be referred toas second outboard rows. The first inboard row 5090 and the firstoutboard row 5092 are located on a first lateral side of thelongitudinal slot 5084 and the second inboard row 5094 and the secondoutboard row 5096 are located on a second lateral side of thelongitudinal slot 5084. The first staple pushers 5088 in the firstinboard row 5092 are staggered in relationship to the first staplepushers 5088 in the first outboard row 5090. Similarly, the secondstaple pushers 5088 in the second outboard row 5096 are staggered inrelationship to the second pushers 5088 in the second inboard row 5094.Each pusher 5088 operably supports a surgical staple 5098 thereon.

In various embodiments, the sequentially-activatable orreciprocatably—activatable drive assembly 5050 includes a pair ofoutboard drivers 5052 and a pair of inboard drivers 5054 that are eachattached to a common shaft 5056 that is rotatably mounted within thebase 5032 of the sled assembly 5030. The outboard drivers 5052 areoriented to sequentially or reciprocatingly engage a correspondingplurality of outboard activation cavities 5026 provided in the channelpan 5022. Likewise, the inboard drivers 5054 are oriented tosequentially or reciprocatingly engage a corresponding plurality ofinboard activation cavities 5028 provided in the channel pan 5022. Theinboard activation cavities 5028 are arranged in a staggeredrelationship relative to the adjacent outboard activation cavities 5026.See FIG. 137. As can also be seen in FIGS. 137 and 139, in at least oneembodiment, the sled assembly 5030 further includes distal wedgesegments 5060 and intermediate wedge segments 5062 located on each sideof the bore 5036 to engage the pushers 5088 as the sled assembly 5030 isdriven distally in the distal direction “DD”. As indicated above, thesled assembly 5030 is threadedly received on a threaded portion 5132 ofa drive shaft 5130 that is rotatably supported within the end effector5012. In various embodiments, for example, the drive shaft 5130 has adistal end 5134 that is supported in a distal bearing 5136 mounted inthe surgical end effector 5012. See FIGS. 136 and 137.

In various embodiments, the surgical end effector 5012 is coupled to atool mounting portion 5200 by an elongated shaft assembly 5108. In atleast one embodiment, the tool mounting portion 5200 operably supports atransmission arrangement generally designated as 5204 that is configuredto receive rotary output motions from the robotic system. The elongatedshaft assembly 5108 includes an outer closure tube 5110 that isrotatable and axially movable on a spine member 5120 that is rigidlycoupled to a tool mounting plate 5201 of the tool mounting portion 5200.The spine member 5120 also has a distal end 5122 that is coupled to theelongated channel portion 5020 of the surgical end effector 5012.

In use, it may be desirable to rotate the surgical end effector 5012about a longitudinal tool axis LT-LT defined by the elongated shaftassembly 5008. In various embodiments, the outer closure tube 5110 has aproximal end 5112 that is rotatably supported on the tool mounting plate5201 of the tool drive portion 5200 by a forward support cradle 5203.The proximal end 5112 of the outer closure tube 5110 is configured tooperably interface with a rotation transmission portion 5206 of thetransmission arrangement 5204. In various embodiments, the proximal end5112 of the outer closure tube 5110 is also supported on a closure sled5140 that is also movably supported on the tool mounting plate 5201. Aclosure tube gear segment 5114 is formed on the proximal end 5112 of theouter closure tube 5110 for meshing engagement with a rotation driveassembly 5150 of the rotation transmission 5206. As can be seen in FIG.134, the rotation drive assembly 5150, in at least one embodiment,comprises a rotation drive gear 5152 that is coupled to a correspondingfirst one of the driven discs or elements 11304 on the adapter side11307 of the tool mounting plate 5201 when the tool drive portion 5200is coupled to the tool holder 11270. The rotation drive assembly 5150further comprises a rotary driven gear 5154 that is rotatably supportedon the tool mounting plate 5201 in meshing engagement with the closuretube gear segment 5114 and the rotation drive gear 5152. Application ofa first rotary control motion from the robotic system 11000 through thetool holder 11270 and the adapter 11240 to the corresponding drivenelement 11304 will thereby cause rotation of the rotation drive gear5152. Rotation of the rotation drive gear 5152 ultimately results in therotation of the elongated shaft assembly 5108 (and the end effector5012) about the longitudinal tool axis LT-LT (represented by arrow “R”in FIG. 134).

Closure of the anvil 5070 relative to the surgical staple cartridge 5080is accomplished by axially moving the outer closure tube 5110 in thedistal direction “DD”. Such axial movement of the outer closure tube5110 may be accomplished by a closure transmission portion 5144 of thetransmission arrangement 5204. As indicated above, in variousembodiments, the proximal end 5112 of the outer closure tube 5110 issupported by the closure sled 5140 which enables the proximal end 5112to rotate relative thereto, yet travel axially with the closure sled5140. In particular, as can be seen in FIG. 134, the closure sled 5140has an upstanding tab 5141 that extends into a radial groove 5115 in theproximal end portion 5112 of the outer closure tube 5110. In addition,as was described above, the closure sled 5140 is slidably mounted to thetool mounting plate 5201. In various embodiments, the closure sled 5140has an upstanding portion 5142 that has a closure rack gear 5143 formedthereon. The closure rack gear 5143 is configured for driving engagementwith the closure transmission 5144.

In various forms, the closure transmission 5144 includes a closure spurgear 5145 that is coupled to a corresponding second one of the drivendiscs or elements 11304 on the adapter side 11307 of the tool mountingplate 5201. Thus, application of a second rotary control motion from therobotic system 11000 through the tool holder 11270 and the adapter 11240to the corresponding second driven element 11304 will cause rotation ofthe closure spur gear 5145 when the interface 11230 is coupled to thetool mounting portion 5200. The closure transmission 5144 furtherincludes a driven closure gear set 5146 that is supported in meshingengagement with the closure spur gear 5145 and the closure rack gear5143. Thus, application of a second rotary control motion from therobotic system 11000 through the tool holder 11270 and the adapter 11240to the corresponding second driven element 11304 will cause rotation ofthe closure spur gear 5145 and ultimately drive the closure sled 5140and the outer closure tube 5110 axially. The axial direction in whichthe closure tube 5110 moves ultimately depends upon the direction inwhich the second driven element 11304 is rotated. For example, inresponse to one rotary closure motion received from the robotic system11000, the closure sled 5140 will be driven in the distal direction “DD”and ultimately the outer closure tube 5110 will be driven in the distaldirection as well. The outer closure tube 5110 has an opening 5117 inthe distal end 5116 that is configured for engagement with a tab 5171 onthe anvil 5070 in the manners described above. As the outer closure tube5110 is driven distally, the proximal end 5116 of the closure tube 5110will contact the anvil 5070 and pivot it closed. Upon application of an“opening” rotary motion from the robotic system 11000, the closure sled5140 and outer closure tube 5110 will be driven in the proximaldirection “PD” and pivot the anvil 5070 to the open position in themanners described above.

In at least one embodiment, the drive shaft 5130 has a proximal end 5137that has a proximal shaft gear 5138 attached thereto. The proximal shaftgear 5138 is supported in meshing engagement with a distal drive gear5162 attached to a rotary drive bar 5160 that is rotatably supportedwith spine member 5120. Rotation of the rotary drive bar 5160 andultimately rotary drive shaft 5130 is controlled by a rotary knifetransmission 5207 which comprises a portion of the transmissionarrangement 5204 supported on the tool mounting plate 5210. In variousembodiments, the rotary knife transmission 5207 comprises a rotary knifedrive system 5170 that is operably supported on the tool mounting plate5201. In various embodiments, the knife drive system 5170 includes arotary drive gear 5172 that is coupled to a corresponding third one ofthe driven discs or elements 11304 on the adapter side of the toolmounting plate 5201 when the tool drive portion 5200 is coupled to thetool holder 11270. The knife drive system 5170 further comprises a firstrotary driven gear 5174 that is rotatably supported on the tool mountingplate 5201 in meshing engagement with a second rotary driven gear 5176and the rotary drive gear 5172. The second rotary driven gear 5176 iscoupled to a proximal end portion 5164 of the rotary drive bar 5160.

Rotation of the rotary drive gear 5172 in a first rotary direction willresult in the rotation of the rotary drive bar 5160 and rotary driveshaft 5130 in a first direction. Conversely, rotation of the rotarydrive gear 5172 in a second rotary direction (opposite to the firstrotary direction) will cause the rotary drive bar 5160 and rotary driveshaft 5130 to rotate in a second direction. Thus, rotation of the driveshaft 5130 results in rotation of the drive sleeve 12400.

One method of operating the surgical tool 5000 will now be described.The tool drive 5200 is operably coupled to the interface 11240 of therobotic system 11000. The controller 11001 of the robotic system 11000is operated to locate the tissue to be cut and stapled between the openanvil 5070 and the surgical staple cartridge 5080. Once the surgical endeffector 5012 has been positioned by the robot system 11000 such thatthe target tissue is located between the anvil 5070 and the surgicalstaple cartridge 5080, the controller 11001 of the robotic system 11000may be activated to apply the second rotary output motion to the seconddriven element 11304 coupled to the closure spur gear 5145 to drive theclosure sled 5140 and the outer closure tube 5110 axially in the distaldirection to pivot the anvil 5070 closed in the manner described above.Once the robotic controller 11001 determines that the anvil 5070 hasbeen closed by, for example, sensors in the surgical end effector 5012and/or the tool drive portion 5200, the robotic controller 11001 systemmay provide the surgeon with an indication that signifies the closure ofthe anvil. Such indication may be, for example, in the form of a lightand/or audible sound, tactile feedback on the control members, etc. Thenthe surgeon may initiate the firing process. In alternative embodiments,however, the robotic controller 11001 may automatically commence thefiring process.

To commence the firing process, the robotic controller applies a thirdrotary output motion to the third driven disc or element 11304 coupledto the rotary drive gear 5172. Rotation of the rotary drive gear 5172results in the rotation of the rotary drive bar 5160 and rotary driveshaft 5130 in the manner described above. Firing and formation of thesurgical staples 5098 can be best understood from reference to FIGS.135, 137, and 138. As the sled assembly 5030 is driven in the distaldirection “DD” through the surgical staple cartridge 5080, the distalwedge segments 5060 first contact the staple pushers 5088 and start tomove them toward the closed anvil 5070. As the sled assembly 5030continues to move distally, the outboard drivers 5052 will drop into thecorresponding activation cavity 5026 in the channel pan 5022. Theopposite end of each outboard driver 5052 will then contact thecorresponding outboard pusher 5088 that has moved up the distal andintermediate wedge segments 5060, 5062. Further distal movement of thesled assembly 5030 causes the outboard drivers 5052 to rotate and drivethe corresponding pushers 5088 toward the anvil 5070 to cause thestaples 5098 supported thereon to be formed as they are driven into theanvil 5070. It will be understood that as the sled assembly 5030 movesdistally, the knife blade 5040 cuts through the tissue that is clampedbetween the anvil and the staple cartridge. Because the inboard drivers5054 and outboard drivers 5052 are attached to the same shaft 5056 andthe inboard drivers 5054 are radially offset from the outboard drivers5052 on the shaft 5056, as the outboard drivers 5052 are driving theircorresponding pushers 5088 toward the anvil 5070, the inboard drivers5054 drop into their next corresponding activation cavity 5028 to causethem to rotatably or reciprocatingly drive the corresponding inboardpushers 5088 towards the closed anvil 5070 in the same manner. Thus, thelaterally corresponding outboard staples 5098 on each side of thecentrally disposed slot 5084 are simultaneously formed together and thelaterally corresponding inboard staples 5098 on each side of the slot5084 are simultaneously formed together as the sled assembly 5030 isdriven distally. Once the robotic controller 11001 determines that thesled assembly 5030 has reached its distal most position—either throughsensors or through monitoring the amount of rotary input applied to thedrive shaft 5130 and/or the rotary drive bar 5160, the controller 11001may then apply a third rotary output motion to the drive shaft 5130 torotate the drive shaft 5130 in an opposite direction to retract the sledassembly 5030 back to its starting position. Once the sled assembly 5030has been retracted to the starting position (as signaled by sensors inthe end effector 5012 and/or the tool drive portion 5200), theapplication of the second rotary motion to the drive shaft 5130 isdiscontinued. Thereafter, the surgeon may manually activate the anvilopening process or it may be automatically commenced by the roboticcontroller 11001. To open the anvil 5070, the second rotary outputmotion is applied to the closure spur gear 5145 to drive the closuresled 5140 and the outer closure tube 5110 axially in the proximaldirection. As the closure tube 5110 moves proximally, the opening 5117in the distal end 5116 of the closure tube 5110 contacts the tab 5171 onthe anvil 5070 to pivot the anvil 5070 to the open position. A springmay also be employed to bias the anvil 5070 to the open position whenthe closure tube 5116 has been returned to the starting position. Again,sensors in the surgical end effector 5012 and/or the tool mountingportion 5200 may provide the robotic controller 11001 with a signalindicating that the anvil 5070 is now open. Thereafter, the surgical endeffector 5012 may be withdrawn from the surgical site.

FIGS. 141-146 diagrammatically depict the sequential firing of staplesin a surgical tool assembly 5000′ that is substantially similar to thesurgical tool assembly 5000 described above. In this embodiment, theinboard and outboard drivers 5052′, 5054′ have a cam-like shape with acam surface 5053 and an actuator protrusion 5055 as shown in FIGS.141-147. The drivers 5052′, 5054′ are journaled on the same shaft 5056′that is rotatably supported by the sled assembly 5030′. In thisembodiment, the sled assembly 5030′ has distal wedge segments 5060′ forengaging the pushers 5088. FIG. 141 illustrates an initial position oftwo inboard or outboard drivers 5052′, 5054′ as the sled assembly 5030′is driven in the distal direction “DD”. As can be seen in that FIG., thepusher 5088 a has advanced up the wedge segment 5060′ and has contactedthe driver 5052′, 5054′. Further travel of the sled assembly 5030′ inthe distal direction causes the driver 5052′, 5054′ to pivot in the “P”direction (FIG. 110) until the actuator portion 5055 contacts the endwall 5029 a of the activation cavity 5026, 5028 as shown in FIG. 143.Continued advancement of the sled assembly 5030′ in the distal direction“DD” causes the driver 5052′, 5054′ to rotate in the “D” direction asshown in FIG. 144. As the driver 5052′, 5054′ rotates, the pusher 5088 arides up the cam surface 5053 to the final vertical position shown inFIG. 145. When the pusher 5088 a reaches the final vertical positionshown in FIGS. 145 and 146, the staple (not shown) supported thereon hasbeen driven into the staple forming surface of the anvil to form thestaple.

FIGS. 148-153 illustrate a surgical end effector 5312 that may beemployed for example, in connection with the tool mounting portion 11300and shaft 12008 described in detail above. In various forms, thesurgical end effector 5312 includes an elongated channel 5322 that isconstructed as described above for supporting a surgical staplecartridge 5330 therein. The surgical staple cartridge 5330 comprises abody portion 5332 that includes a centrally disposed slot 5334 foraccommodating an upstanding support portion 5386 of a sled assembly5380. See FIGS. 148-150. The surgical staple cartridge body portion 5332further includes a plurality of cavities 5336 for movably supportingstaple-supporting pushers 5350 therein. The cavities 5336 may bearranged in spaced longitudinally extending rows 5340, 5342, 5344, 5346.The rows 5340, 5342 are located on one lateral side of the longitudinalslot 5334 and the rows 5344, 5346 are located on the other side oflongitudinal slot 5334. In at least one embodiment, the pushers 5350 areconfigured to support two surgical staples 5352 thereon. In particular,each pusher 5350 located on one side of the elongated slot 5334 supportsone staple 5352 in row 5340 and one staple 5352 in row 5342 in astaggered orientation. Likewise, each pusher 5350 located on the otherside of the elongated slot 5334 supports one surgical staple 5352 in row5344 and another surgical staple 5352 in row 5346 in a staggeredorientation. Thus, every pusher 5350 supports two surgical staples 5352.

As can be further seen in FIGS. 148, 149, the surgical staple cartridge5330 includes a plurality of rotary drivers 5360. More particularly, therotary drivers 5360 on one side of the elongated slot 5334 are arrangedin a single line 5370 and correspond to the pushers 5350 in lines 5340,5342. In addition, the rotary drivers 5360 on the other side of theelongated slot 5334 are arranged in a single line 5372 and correspond tothe pushers 5350 in lines 5344, 5346. As can be seen in FIG. 148, eachrotary driver 5360 is rotatably supported within the staple cartridgebody 5332. More particularly, each rotary driver 5360 is rotatablyreceived on a corresponding driver shaft 5362. Each driver 5360 has anarcuate ramp portion 5364 formed thereon that is configured to engage anarcuate lower surface 5354 formed on each pusher 5350. See FIG. 153. Inaddition, each driver 5360 has a lower support portion 5366 extendtherefrom to slidably support the pusher 5360 on the channel 5322. Eachdriver 5360 has a downwardly extending actuation rod 5368 that isconfigured for engagement with a sled assembly 5380.

As can be seen in FIG. 150, in at least one embodiment, the sledassembly 5380 includes a base portion 5382 that has a foot portion 5384that is sized to be slidably received in a slot 5333 in the channel5322. See FIG. 148. The sled assembly 5380 includes an upstandingsupport portion 5386 that supports a tissue cutting blade or tissuecutting instrument 5388. The upstanding support portion 5386 terminatesin a top portion 5390 that has a pair of laterally extending retainingfins 5392 protruding therefrom. The fins 5392 are positioned to bereceived within corresponding slots (not shown) in the anvil (notshown). As with the above-described embodiments, the fins 5392 and thefoot portion 5384 serve to retain the anvil (not shown) in a desiredspaced closed position as the sled assembly 5380 is driven distallythrough the tissue clamped within the surgical end effector 5312. Theupstanding support portion 5386 is configured for attachment to a knifebar 12200 (FIG. 69). The sled assembly 5380 further has ahorizontally-extending actuator plate 5394 that is shaped for actuatingengagement with each of the actuation rods 5368 on the pushers 5360.

Operation of the surgical end effector 5312 will now be explained withreference to FIGS. 148 and 149. As the sled assembly 5380 is driven inthe distal direction “DD” through the staple cartridge 5330, theactuator plate 5394 sequentially contacts the actuation rods 5368 on thepushers 5360. As the sled assembly 5380 continues to move distally, theactuator plate 5394 sequentially contacts the actuator rods 5368 of thedrivers 5360 on each side of the elongated slot 5334. Such action causesthe drivers 5360 to rotate from a first unactuated position to anactuated portion wherein the pushers 5350 are driven towards the closedanvil. As the pushers 5350 are driven toward the anvil, the surgicalstaples 5352 thereon are driven into forming contact with the undersideof the anvil. Once the robotic system 11000 determines that the sledassembly 5080 has reached its distal most position through sensors orother means, the control system of the robotic system 11000 may thenretract the knife bar and sled assembly 5380 back to the startingposition. Thereafter, the robotic control system may then activate theprocedure for returning the anvil to the open position to release thestapled tissue.

FIGS. 154-158 depict one form of an automated reloading systemembodiment of the present invention, generally designated as 5500. Inone form, the automated reloading system 5500 is configured to replace a“spent” surgical end effector component in a manipulatable surgical toolportion of a robotic surgical system with a “new” surgical end effectorcomponent. As used herein, the term “surgical end effector component”may comprise, for example, a surgical staple cartridge, a disposableloading unit or other end effector components that, when used, are spentand must be replaced with a new component. Furthermore, the term “spent”means that the end effector component has been activated and is nolonger useable for its intended purpose in its present state. Forexample, in the context of a surgical staple cartridge or disposableloading unit, the term “spent” means that at least some of the unformedstaples that were previously supported therein have been “fired”therefrom. As used herein, the term “new” surgical end effectorcomponent refers to an end effector component that is in condition forits intended use. In the context of a surgical staple cartridge ordisposable loading unit, for example, the term “new” refers to such acomponent that has unformed staples therein and which is otherwise readyfor use.

In various embodiments, the automated reloading system 5500 includes abase portion 5502 that may be strategically located within a workenvelope 11109 of a robotic arm cart 11100 (FIG. 55) of a robotic system11000. As used herein, the term “manipulatable surgical tool portion”collectively refers to a surgical tool of the various types disclosedherein and other forms of surgical robotically-actuated tools that areoperably attached to, for example, a robotic arm cart 11100 or similardevice that is configured to automatically manipulate and actuate thesurgical tool. The term “work envelope” as used herein refers to therange of movement of the manipulatable surgical tool portion of therobotic system. FIG. 55 generally depicts an area that may comprise awork envelope of the robotic arm cart 11100. Those of ordinary skill inthe art will understand that the shape and size of the work envelopedepicted therein is merely illustrative. The ultimate size, shape andlocation of a work envelope will ultimately depend upon theconstruction, range of travel limitations, and location of themanipulatable surgical tool portion. Thus, the term “work envelope” asused herein is intended to cover a variety of different sizes and shapesof work envelopes and should not be limited to the specific size andshape of the sample work envelope depicted in FIG. 55.

As can be seen in FIG. 154, the base portion 5502 includes a newcomponent support section or arrangement 5510 that is configured tooperably support at least one new surgical end effector component in a“loading orientation”. As used herein, the term “loading orientation”means that the new end effector component is supported in such away soas to permit the corresponding component support portion of themanipulatable surgical tool portion to be brought into loadingengagement with (i.e., operably seated or operably attached to) the newend effector component (or the new end effector component to be broughtinto loading engagement with the corresponding component support portionof the manipulatable surgical tool portion) without human interventionbeyond that which may be necessary to actuate the robotic system. Aswill be further appreciated as the present Detailed Descriptionproceeds, in at least one embodiment, the preparation nurse will loadthe new component support section before the surgery with theappropriate length and color cartridges (some surgical staple cartridgesmay support certain sizes of staples the size of which may be indicatedby the color of the cartridge body) required for completing the surgicalprocedure. However, no direct human interaction is necessary during thesurgery to reload the robotic endocutter. In one form, the surgical endeffector component comprises a staple cartridge 12034 that is configuredto be operably seated within a component support portion (elongatedchannel) of any of the various other end effector arrangements describedabove. For explanation purposes, new (unused) cartridges will bedesignated as “12034 a” and spent cartridges will be designated as“12034 b”. The FIGS. depict cartridges 12034 a, 12034 b designed for usewith a surgical end effector 12012 that includes a channel 12022 and ananvil 12024, the construction and operation of which were discussed indetail above. Cartridges 12034 a, 12034 b are identical to cartridges12034 described above. In various embodiments, the cartridges 12034 a,12034 b are configured to be snappingly retained (i.e., loadingengagement) within the channel 12022 of a surgical end effector 12012.As the present Detailed Description proceeds, however, those of ordinaryskill in the art will appreciate that the unique and novel features ofthe automated cartridge reloading system 5500 may be effectivelyemployed in connection with the automated removal and installation ofother cartridge arrangements without departing from the spirit and scopeof the present invention.

In the depicted embodiment, the term “loading orientation” means thatthe distal tip portion 12035 a of the a new surgical staple cartridge12034 a is inserted into a corresponding support cavity 5512 in the newcartridge support section 5510 such that the proximal end portion 12037a of the new surgical staple cartridge 12034 a is located in aconvenient orientation for enabling the arm cart 11100 to manipulate thesurgical end effector 12012 into a position wherein the new cartridge12034 a may be automatically loaded into the channel 12022 of thesurgical end effector 12012. In various embodiments, the base 5502includes at least one sensor 5504 which communicates with the controlsystem 11003 of the robotic controller 11001 to provide the controlsystem 11003 with the location of the base 5502 and/or the reload lengthand color doe each staged or new cartridge 12034 a.

As can also be seen in the FIGS., the base 5502 further includes acollection receptacle 5520 that is configured to collect spentcartridges 12034 b that have been removed or disengaged from thesurgical end effector 12012 that is operably attached to the roboticsystem 11000. In addition, in one form, the automated reloading system5500 includes an extraction system 5530 for automatically removing thespent end effector component from the corresponding support portion ofthe end effector or manipulatable surgical tool portion without specifichuman intervention beyond that which may be necessary to activate therobotic system. In various embodiments, the extraction system 5530includes an extraction hook member 5532. In one form, for example, theextraction hook member 5532 is rigidly supported on the base portion5502. In one embodiment, the extraction hook member has at least onehook 5534 formed thereon that is configured to hookingly engage thedistal end 12035 of a spent cartridge 2034 b when it is supported in theelongated channel 12022 of the surgical end effector 12012. In variousforms, the extraction hook member 5532 is conveniently located within aportion of the collection receptacle 5520 such that when the spent endeffector component (cartridge 12034 b) is brought into extractiveengagement with the extraction hook member 5532, the spent end effectorcomponent (cartridge 12034 b) is dislodged from the correspondingcomponent support portion (elongated channel 12022), and falls into thecollection receptacle 5020. Thus, to use this embodiment, themanipulatable surgical tool portion manipulates the end effectorattached thereto to bring the distal end 12035 of the spent cartridge12034 b therein into hooking engagement with the hook 5534 and thenmoves the end effector in such a way to dislodge the spent cartridge12034 b from the elongated channel 12022.

In other arrangements, the extraction hook member 5532 comprises arotatable wheel configuration that has a pair of diametrically-opposedhooks 5334 protruding therefrom. See FIGS. 154 and 157. The extractionhook member 5532 is rotatably supported within the collection receptacle5520 and is coupled to an extraction motor 5540 that is controlled bythe controller 11001 of the robotic system. This form of the automatedreloading system 5500 may be used as follows. FIG. 156 illustrates theintroduction of the surgical end effector 12012 that is operablyattached to the manipulatable surgical tool portion 11200. As can beseen in that FIG., the arm cart 11100 of the robotic system 11000locates the surgical end effector 12012 in the shown position whereinthe hook end 5534 of the extraction member 5532 hookingly engages thedistal end 12035 of the spent cartridge 12034 b in the surgical endeffector 12012. The anvil 12024 of the surgical end effector 12012 is inthe open position. After the distal end 12035 of the spent cartridge12034 b is engaged with the hook end 5532, the extraction motor 5540 isactuated to rotate the extraction wheel 5532 to disengage the spentcartridge 12034 b from the channel 12022. To assist with thedisengagement of the spent cartridge 12034 b from the channel 12022 (orif the extraction member 5530 is stationary), the robotic system 11000may move the surgical end effector 12012 in an upward direction (arrow“U” in FIG. 157). As the spent cartridge 12034 b is dislodged from thechannel 12022, the spent cartridge 12034 b falls into the collectionreceptacle 5520. Once the spent cartridge 12034 b has been removed fromthe surgical end effector 12012, the robotic system 11000 moves thesurgical end effector 12012 to the position shown in FIG. 158.

In various embodiments, a sensor arrangement 5533 is located adjacent tothe extraction member 5532 that is in communication with the controller11001 of the robotic system 11000. The sensor arrangement 5533 maycomprise a sensor that is configured to sense the presence of thesurgical end effector 12012 and, more particularly the tip 12035 b ofthe spent surgical staple cartridge 12034 b thereof as the distal tipportion 12035 b is brought into engagement with the extraction member5532. In some embodiments, the sensor arrangement 5533 may comprise, forexample, a light curtain arrangement. However, other forms of proximitysensors may be employed. In such arrangement, when the surgical endeffector 12012 with the spent surgical staple cartridge 12034 b isbrought into extractive engagement with the extraction member 5532, thesensor senses the distal tip 12035 b of the surgical staple cartridge12034 b (e.g., the light curtain is broken). When the extraction member5532 spins and pops the surgical staple cartridge 12034 b loose and itfalls into the collection receptacle 5520, the light curtain is againunbroken. Because the surgical end effector 12012 was not moved duringthis procedure, the robotic controller 11001 is assured that the spentsurgical staple cartridge 12034 b has been removed therefrom. Othersensor arrangements may also be successfully employed to provide therobotic controller 11001 with an indication that the spent surgicalstaple cartridge 2034 b has been removed from the surgical end effector12012.

As can be seen in FIG. 158, the surgical end effector 12012 ispositioned to grasp a new surgical staple cartridge 12034 a between thechannel 12022 and the anvil 12024. More specifically, as shown in FIGS.155 and 158, each cavity 5512 has a corresponding upstanding pressurepad 5514 associated with it. The surgical end effector 12012 is locatedsuch that the pressure pad 5514 is located between the new cartridge12034 a and the anvil 12024. Once in that position, the robotic system11000 closes the anvil 12024 onto the pressure pad 5514 which serves topush the new cartridge 12034 a into snapping engagement with the channel12022 of the surgical end effector 12012. Once the new cartridge 12034 ahas been snapped into position within the elongated channel 12022, therobotic system 11000 then withdraws the surgical end effector 12012 fromthe automated cartridge reloading system 5500 for use in connection withperforming another surgical procedure.

FIGS. 159-163 depict another automated reloading system 5600 that may beused to remove a spent disposable loading unit 3612 from a manipulatablesurgical tool arrangement 3600 (FIGS. 106-119) that is operably attachedto an arm cart 11100 or other portion of a robotic system 11000 andreload a new disposable loading unit 3612 therein. As can be seen inFIGS. 159 and 160, one form of the automated reloading system 5600includes a housing 5610 that has a movable support assembly in the formof a rotary carrousel top plate 5620 supported thereon which cooperateswith the housing 5610 to form a hollow enclosed area 5612. The automatedreloading system 5600 is configured to be operably supported within thework envelop of the manipulatable surgical tool portion of a roboticsystem as was described above. In various embodiments, the rotarycarrousel plate 5620 has a plurality of holes 5622 for supporting aplurality of orientation tubes 5660 therein. As can be seen in FIGS. 160and 161, the rotary carrousel plate 5620 is affixed to a spindle shaft5624. The spindle shaft 5624 is centrally disposed within the enclosedarea 5612 and has a spindle gear 5626 attached thereto. The spindle gear5626 is in meshing engagement with a carrousel drive gear 5628 that iscoupled to a carrousel drive motor 5630 that is in operativecommunication with the robotic controller 11001 of the robotic system11000.

Various embodiments of the automated reloading system 5600 may alsoinclude a carrousel locking assembly, generally designated as 5640. Invarious forms, the carrousel locking assembly 5640 includes a cam disc5642 that is affixed to the spindle shaft 5624. The spindle gear 5626may be attached to the underside of the cam disc 5642 and the cam disc5642 may be keyed onto the spindle shaft 5624. In alternativearrangements, the spindle gear 5626 and the cam disc 5642 may beindependently non-rotatably affixed to the spindle shaft 5624. As can beseen in FIGS. 160 and 161, a plurality of notches 5644 are spaced aroundthe perimeter of the cam disc 5642. A locking arm 5648 is pivotallymounted within the housing 5610 and is biased into engagement with theperimeter of the cam disc 5642 by a locking spring 5649. As can be seenin FIG. 159, the outer perimeter of the cam disc 5642 is rounded tofacilitate rotation of the cam disc 5642 relative to the locking arm5648. The edges of each notch 5644 are also rounded such that when thecam disc 5642 is rotated, the locking arm 5648 is cammed out ofengagement with the notches 5644 by the perimeter of the cam disc 5642.

Various forms of the automated reloading system 5600 are configured tosupport a portable/replaceable tray assembly 5650 that is configured tosupport a plurality of disposable loading units 3612 in individualorientation tubes 5660. More specifically and with reference to FIGS.160 and 161, the replaceable tray assembly 5650 comprises a tray 5652that has a centrally-disposed locator spindle 5654 protruding from theunderside thereof. The locator spindle 5654 is sized to be receivedwithin a hollow end 5625 of spindle shaft 5624. The tray 5652 has aplurality of holes 5656 therein that are configured to support anorientation tube 5660 therein. Each orientation tube 5660 is orientedwithin a corresponding hole 5656 in the replaceable tray assembly 5650in a desired orientation by a locating fin 5666 on the orientation tube5660 that is designed to be received within a corresponding locatingslot 5658 in the tray assembly 5650. In at least one embodiment, thelocating fin 5666 has a substantially V-shaped cross-sectional shapethat is sized to fit within a V-shaped locating slot 5658. Sucharrangement serves to orient the orientation tube 5660 in a desiredstarting position while enabling it to rotate within the hole 5656 whena rotary motion is applied thereto. That is, when a rotary motion isapplied to the orientation tube 5660 the V-shaped locating fin 5666 willpop out of its corresponding locating slot enabling the tube 5660 torotate relative to the tray 5652 as will be discussed in further detailbelow. As can also be seen in FIGS. 159-161, the replaceable tray 5652may be provided with one or more handle portions 5653 to facilitatetransport of the tray assembly 5652 when loaded with orientation tubes5660.

As can be seen in FIG. 162, each orientation tube 5660 comprises a bodyportion 5662 that has a flanged open end 5664. The body portion 5662defines a cavity 5668 that is sized to receive a portion of a disposableloading unit 3612 therein. To properly orient the disposable loadingunit 3612 within the orientation tube 5660, the cavity 5668 has a flatlocating surface 5670 formed therein. As can be seen in FIG. 163, theflat locating surface 5670 is configured to facilitate the insertion ofthe disposable loading unit into the cavity 5668 in a desired orpredetermined non-rotatable orientation. In addition, the end 5669 ofthe cavity 5668 may include a foam or cushion material 5672 that isdesigned to cushion the distal end of the disposable loading unit 3612within the cavity 5668. Also, the length of the locating surface maycooperate with a sliding support member 3689 of the axial drive assembly3680 of the disposable loading unit 3612 to further locate thedisposable loading unit 3612 at a desired position within theorientation tube 5660.

The orientation tubes 5660 may be fabricated from Nylon, polycarbonate,polyethylene, liquid crystal polymer, 6061 or 7075 aluminum, titanium,300 or 400 series stainless steel, coated or painted steel, platedsteel, etc. and, when loaded in the replaceable tray 5662 and thelocator spindle 5654 is inserted into the hollow end 5625 of spindleshaft 5624, the orientation tubes 5660 extend through correspondingholes 5662 in the carrousel top plate 5620. Each replaceable tray 5662is equipped with a location sensor 5663 that communicates with thecontrol system 11003 of the controller 11001 of the robotic system11000. The sensor 5663 serves to identify the location of the reloadsystem, and the number, length, color and fired status of each reloadhoused in the tray. In addition, an optical sensor or sensors 5665 thatcommunicate with the robotic controller 11001 may be employed to sensethe type/size/length of disposable loading units that are loaded withinthe tray 5662.

Various embodiments of the automated reloading system 5600 furtherinclude a drive assembly 5680 for applying a rotary motion to theorientation tube 5660 holding the disposable loading unit 3612 to beattached to the shaft 3700 of the surgical tool 3600 (collectively the“manipulatable surgical tool portion”) that is operably coupled to therobotic system. The drive assembly 5680 includes a support yoke 5682that is attached to the locking arm 5648. Thus, the support yoke 5682pivots with the locking arm 5648. The support yoke 5682 rotatablysupports a tube idler wheel 5684 and a tube drive wheel 5686 that isdriven by a tube motor 5688 attached thereto. Tube motor 5688communicates with the control system 11003 and is controlled thereby.The tube idler wheel 5684 and tube drive wheel 5686 are fabricated from,for example, natural rubber, sanoprene, isoplast, etc. such that theouter surfaces thereof create sufficient amount of friction to result inthe rotation of an orientation tube 5660 in contact therewith uponactivation of the tube motor 5688. The idler wheel 5684 and tube drivewheel 5686 are oriented relative to each other to create a cradle area5687 therebetween for receiving an orientation tube 5060 in drivingengagement therein.

In use, one or more of the orientation tubes 5660 loaded in theautomated reloading system 5600 are left empty, while the otherorientation tubes 5660 may operably support a corresponding newdisposable loading unit 3612 therein. As will be discussed in furtherdetail below, the empty orientation tubes 5660 are employed to receive aspent disposable loading unit 3612 therein.

The automated reloading system 5600 may be employed as follows after thesystem 5600 is located within the work envelope of the manipulatablesurgical tool portion of a robotic system. If the manipulatable surgicaltool portion has a spent disposable loading unit 3612 operably coupledthereto, one of the orientation tubes 5660 that are supported on thereplaceable tray 5662 is left empty to receive the spent disposableloading unit 3612 therein. If, however, the manipulatable surgical toolportion does not have a disposable loading unit 3612 operably coupledthereto, each of the orientation tubes 5660 may be provided with aproperly oriented new disposable loading unit 3612.

As described hereinabove, the disposable loading unit 3612 employs arotary “bayonet-type” coupling arrangement for operably coupling thedisposable loading unit 3612 to a corresponding portion of themanipulatable surgical tool portion. That is, to attach a disposableloading unit 3612 to the corresponding portion of the manipulatablesurgical tool portion (3700—see FIG. 112, 113), a rotary installationmotion must be applied to the disposable loading unit 3612 and/or thecorresponding portion of the manipulatable surgical tool portion whenthose components have been moved into loading engagement with eachother. Such installation motions are collectively referred to herein as“loading motions”. Likewise, to decouple a spent disposable loading unit3612 from the corresponding portion of the manipulatable surgical tool,a rotary decoupling motion must be applied to the spent disposableloading unit 3612 and/or the corresponding portion of the manipulatablesurgical tool portion while simultaneously moving the spent disposableloading unit and the corresponding portion of the manipulatable surgicaltool away from each other. Such decoupling motions are collectivelyreferred to herein as “extraction motions”.

To commence the loading process, the robotic system 11000 is activatedto manipulate the manipulatable surgical tool portion and/or theautomated reloading system 5600 to bring the manipulatable surgical toolportion into loading engagement with the new disposable loading unit3612 that is supported in the orientation tube 5660 that is in drivingengagement with the drive assembly 5680. Once the robotic controller11001 (FIG. 54) of the robotic control system 11000 has located themanipulatable surgical tool portion in loading engagement with the newdisposable loading unit 3612, the robotic controller 11001 activates thedrive assembly 5680 to apply a rotary loading motion to the orientationtube 5660 in which the new disposable loading unit 3612 is supportedand/or applies another rotary loading motion to the correspondingportion of the manipulatable surgical tool portion. Upon application ofsuch rotary loading motions(s), the robotic controller 11001 also causesthe corresponding portion of the manipulatable surgical tool portion tobe moved towards the new disposable loading unit 3612 into loadingengagement therewith. Once the disposable loading unit 3612 is inloading engagement with the corresponding portion of the manipulatabletool portion, the loading motions are discontinued and the manipulatablesurgical tool portion may be moved away from the automated reloadingsystem 5600 carrying with it the new disposable loading unit 3612 thathas been operably coupled thereto.

To decouple a spent disposable loading unit 3612 from a correspondingmanipulatable surgical tool portion, the robotic controller 11001 of therobotic system manipulates the manipulatable surgical tool portion so asto insert the distal end of the spent disposable loading unit 3612 intothe empty orientation tube 5660 that remains in driving engagement withthe drive assembly 5680. Thereafter, the robotic controller 11001activates the drive assembly 5680 to apply a rotary extraction motion tothe orientation tube 5660 in which the spent disposable loading unit3612 is supported and/or applies a rotary extraction motion to thecorresponding portion of the manipulatable surgical tool portion. Therobotic controller 11001 also causes the manipulatable surgical toolportion to withdraw away from the spent rotary disposable loading unit3612. Thereafter the rotary extraction motion(s) are discontinued.

After the spent disposable loading unit 3612 has been removed from themanipulatable surgical tool portion, the robotic controller 11001 mayactivate the carrousel drive motor 5630 to index the carrousel top plate5620 to bring another orientation tube 5660 that supports a newdisposable loading unit 3612 therein into driving engagement with thedrive assembly 5680. Thereafter, the loading process may be repeated toattach the new disposable loading unit 3612 therein to the portion ofthe manipulatable surgical tool portion. The robotic controller 11001may record the number of disposable loading units that have been usedfrom a particular replaceable tray 5652. Once the controller 11001determines that all of the new disposable loading units 3612 have beenused from that tray, the controller 11001 may provide the surgeon with asignal (visual and/or audible) indicating that the tray 5652 supportingall of the spent disposable loading units 3612 must be replaced with anew tray 5652 containing new disposable loading units 3612.

FIGS. 164-169 depict another non-limiting embodiment of a surgical tool6000 of the present invention that is well-adapted for use with arobotic system 11000 that has a tool drive assembly 11010 (FIG. 59) thatis operatively coupled to a master controller 11001 that is operable byinputs from an operator (i.e., a surgeon). As can be seen in FIG. 164,the surgical tool 6000 includes a surgical end effector 6012 thatcomprises an endocutter. In at least one form, the surgical tool 6000generally includes an elongated shaft assembly 6008 that has a proximalclosure tube 6040 and a distal closure tube 6042 that are coupledtogether by an articulation joint 6100. The surgical tool 6000 isoperably coupled to the manipulator by a tool mounting portion,generally designated as 6200. The surgical tool 6000 further includes aninterface 6030 which may mechanically and electrically couple the toolmounting portion 6200 to the manipulator in the various mannersdescribed in detail above.

In at least one embodiment, the surgical tool 6000 includes a surgicalend effector 6012 that comprises, among other things, at least onecomponent 6024 that is selectively movable between first and secondpositions relative to at least one other component 6022 in response tovarious control motions applied to component 6024 as will be discussedin further detail below to perform a surgical procedure. In variousembodiments, component 6022 comprises an elongated channel 6022configured to operably support a surgical staple cartridge 6034 thereinand component 6024 comprises a pivotally translatable clamping member,such as an anvil 6024. Various embodiments of the surgical end effector6012 are configured to maintain the anvil 6024 and elongated channel6022 at a spacing that assures effective stapling and severing of tissueclamped in the surgical end effector 6012. Unless otherwise stated, theend effector 6012 is similar to the surgical end effector 12012described above and includes a cutting instrument (not shown) and a sled(not shown). The anvil 6024 may include a tab 6027 at its proximal endthat interacts with a component of the mechanical closure system(described further below) to facilitate the opening of the anvil 6024.The elongated channel 6022 and the anvil 6024 may be made of anelectrically conductive material (such as metal) so that they may serveas part of an antenna that communicates with sensor(s) in the endeffector, as described above. The surgical staple cartridge 6034 couldbe made of a nonconductive material (such as plastic) and the sensor maybe connected to or disposed in the surgical staple cartridge 6034, aswas also described above.

As can be seen in FIG. 164, the surgical end effector 6012 is attachedto the tool mounting portion 6200 by the elongated shaft assembly 6008according to various embodiments. As shown in the illustratedembodiment, the elongated shaft assembly 6008 includes an articulationjoint generally designated as 6100 that enables the surgical endeffector 6012 to be selectively articulated about a first toolarticulation axis AA1-AA1 that is substantially transverse to alongitudinal tool axis LT-LT and a second tool articulation axis AA2-AA2that is substantially transverse to the longitudinal tool axis LT-LT aswell as the first articulation axis AA1-AA1. See FIG. 165. In variousembodiments, the elongated shaft assembly 6008 includes a closure tubeassembly 6009 that comprises a proximal closure tube 6040 and a distalclosure tube 6042 that are pivotably linked by a pivot links 6044 and6046. The closure tube assembly 6009 is movably supported on a spineassembly generally designated as 6102.

As can be seen in FIG. 166, the proximal closure tube 6040 is pivotallylinked to an intermediate closure tube joint 6043 by an upper pivot link6044U and a lower pivot link 6044L such that the intermediate closuretube joint 6043 is pivotable relative to the proximal closure tube 6040about a first closure axis CA1-CA1 and a second closure axis CA2-CA2. Invarious embodiments, the first closure axis CA1-CA1 is substantiallyparallel to the second closure axis CA2-CA2 and both closure axesCA1-CA1, CA2-CA2 are substantially transverse to the longitudinal toolaxis LT-LT. As can be further seen in FIG. 134, the intermediate closuretube joint 6043 is pivotally linked to the distal closure tube 6042 by aleft pivot link 6046L and a right pivot link 6046R such that theintermediate closure tube joint 6043 is pivotable relative to the distalclosure tube 6042 about a third closure axis CA3-CA3 and a fourthclosure axis CA4-CA4. In various embodiments, the third closure axisCA3-CA3 is substantially parallel to the fourth closure axis CA4-CA4 andboth closure axes CA3-CA3, CA4-CA4 are substantially transverse to thefirst and second closure axes CA1-CA1, CA2-CA2 as well as tolongitudinal tool axis LT-LT.

The closure tube assembly 6009 is configured to axially slide on thespine assembly 6102 in response to actuation motions applied thereto.The distal closure tube 6042 includes an opening 6045 which interfaceswith the tab 6027 on the anvil 6024 to facilitate opening of the anvil6024 as the distal closure tube 6042 is moved axially in the proximaldirection “PD”. The closure tubes 6040, 6042 may be made of electricallyconductive material (such as metal) so that they may serve as part ofthe antenna, as described above. Components of the spine assembly 6102may be made of a nonconductive material (such as plastic).

As indicated above, the surgical tool 6000 includes a tool mountingportion 6200 that is configured for operable attachment to the toolmounting assembly 11010 of the robotic system 11000 in the variousmanners described in detail above. As can be seen in FIG. 168, the toolmounting portion 6200 comprises a tool mounting plate 6202 that operablysupports a transmission arrangement 6204 thereon. In variousembodiments, the transmission arrangement 6204 includes an articulationtransmission 6142 that comprises a portion of an articulation system6140 for articulating the surgical end effector 6012 about a first toolarticulation axis TA1-TA1 and a second tool articulation axis TA2-TA2.The first tool articulation axis TA1-TA1 is substantially transverse tothe second tool articulation axis TA2-TA2 and both of the first andsecond tool articulation axes are substantially transverse to thelongitudinal tool axis LT-LT. See FIG. 165.

To facilitate selective articulation of the surgical end effector 6012about the first and second tool articulation axes TA1-TA1, TA2-TA2, thespine assembly 6102 comprises a proximal spine portion 6110 that ispivotally coupled to a distal spine portion 6120 by pivot pins 6122 forselective pivotal travel about TA1-TA1. Similarly, the distal spineportion 6120 is pivotally attached to the elongated channel 6022 of thesurgical end effector 6012 by pivot pins 6124 to enable the surgical endeffector 6012 to selectively pivot about the second tool axis TA2-TA2relative to the distal spine portion 6120.

In various embodiments, the articulation system 6140 further includes aplurality of articulation elements that operably interface with thesurgical end effector 6012 and an articulation control arrangement 6160that is operably supported in the tool mounting member 6200 as willdescribed in further detail below. In at least one embodiment, thearticulation elements comprise a first pair of first articulation cables6144 and 6146. The first articulation cables are located on a first orright side of the longitudinal tool axis. Thus, the first articulationcables are referred to herein as a right upper cable 6144 and a rightlower cable 6146. The right upper cable 6144 and the right lower cable6146 extend through corresponding passages 6147, 6148, respectivelyalong the right side of the proximal spine portion 6110. See FIG. 169.The articulation system 6140 further includes a second pair of secondarticulation cables 6150, 6152. The second articulation cables arelocated on a second or left side of the longitudinal tool axis. Thus,the second articulation cables are referred to herein as a left upperarticulation cable 6150 and a left articulation cable 6152. The leftupper articulation cable 6150 and the left lower articulation cable 6152extend through passages 6153, 6154, respectively in the proximal spineportion 6110.

As can be seen in FIG. 165, the right upper cable 6144 extends around anupper pivot joint 6123 and is attached to a left upper side of theelongated channel 6022 at a left pivot joint 6125. The right lower cable6146 extends around a lower pivot joint 6126 and is attached to a leftlower side of the elongated channel 6022 at left pivot joint 6125. Theleft upper cable 6150 extends around the upper pivot joint 6123 and isattached to a right upper side of the elongated channel 6022 at a rightpivot joint 6127. The left lower cable 6152 extends around the lowerpivot joint 6126 and is attached to a right lower side of the elongatedchannel 6022 at right pivot joint 6127. Thus, to pivot the surgical endeffector 6012 about the first tool articulation axis TA1-TA1 to the left(arrow “L”), the right upper cable 6144 and the right lower cable 6146must be pulled in the proximal direction “PD”. To articulate thesurgical end effector 6012 to the right (arrow “R”) about the first toolarticulation axis TA1-TA1, the left upper cable 6150 and the left lowercable 6152 must be pulled in the proximal direction “PD”. To articulatethe surgical end effector 6012 about the second tool articulation axisTA2-TA2, in an upward direction (arrow “U”), the right upper cable 6144and the left upper cable 6150 must be pulled in the proximal direction“PD”. To articulate the surgical end effector 6012 in the downwarddirection (arrow “DW”) about the second tool articulation axis TA2-TA2,the right lower cable 6146 and the left lower cable 6152 must be pulledin the proximal direction “PD”.

The proximal ends of the articulation cables 6144, 6146, 6150, 6152 arecoupled to the articulation control arrangement 6160 which comprises aball joint assembly that is a part of the articulation transmission6142. More specifically and with reference to FIG. 169, the ball jointassembly 6160 includes a ball-shaped member 6162 that is formed on aproximal portion of the proximal spine 6110. Movably supported on theball-shaped member 6162 is an articulation control ring 6164. As can befurther seen in FIG. 169, the proximal ends of the articulation cables6144, 6146, 6150, 6152 are coupled to the articulation control ring 6164by corresponding ball joint arrangements 6166. The articulation controlring 6164 is controlled by an articulation drive assembly 6170. As canbe most particularly seen in FIG. 169, the proximal ends of the firstarticulation cables 6144, 6146 are attached to the articulation controlring 6164 at corresponding spaced first points 6149, 6151 that arelocated on plane 6159. Likewise, the proximal ends of the secondarticulation cables 6150, 6152 are attached to the articulation controlring 6164 at corresponding spaced second points 6153, 6155 that are alsolocated along plane 6159. As the present Detailed Description proceeds,those of ordinary skill in the art will appreciate that such cableattachment configuration on the articulation control ring 6164facilitates the desired range of articulation motions as thearticulation control ring 6164 is manipulated by the articulation driveassembly 6170.

In various forms, the articulation drive assembly 6170 comprises ahorizontal articulation assembly generally designated as 6171. In atleast one form, the horizontal articulation assembly 6171 comprises ahorizontal push cable 6172 that is attached to a horizontal geararrangement 6180. The articulation drive assembly 6170 further comprisesa vertically articulation assembly generally designated as 6173. In atleast one form, the vertical articulation assembly 6173 comprises avertical push cable 6174 that is attached to a vertical gear arrangement6190. As can be seen in FIGS. 168 and 169, the horizontal push cable6172 extends through a support plate 6167 that is attached to theproximal spine portion 6110. The distal end of the horizontal push cable6174 is attached to the articulation control ring 6164 by acorresponding ball/pivot joint 6168. The vertical push cable 6174extends through the support plate 6167 and the distal end thereof isattached to the articulation control ring 6164 by a correspondingball/pivot joint 6169.

The horizontal gear arrangement 6180 includes a horizontal driven gear6182 that is pivotally mounted on a horizontal shaft 6181 that isattached to a proximal portion of the proximal spine portion 6110. Theproximal end of the horizontal push cable 6172 is pivotally attached tothe horizontal driven gear 6182 such that, as the horizontal driven gear6172 is rotated about horizontal pivot axis HA, the horizontal pushcable 6172 applies a first pivot motion to the articulation control ring6164. Likewise, the vertical gear arrangement 6190 includes a verticaldriven gear 6192 that is pivotally supported on a vertical shaft 6191attached to the proximal portion of the proximal spine portion 6110 forpivotal travel about a vertical pivot axis VA. The proximal end of thevertical push cable 6174 is pivotally attached to the vertical drivengear 6192 such that as the vertical driven gear 6192 is rotated aboutvertical pivot axis VA, the vertical push cable 6174 applies a secondpivot motion to the articulation control ring 6164.

The horizontal driven gear 6182 and the vertical driven gear 6192 aredriven by an articulation gear train 6300 that operably interfaces withan articulation shifter assembly 6320. In at least one form, thearticulation shifter assembly comprises an articulation drive gear 6322that is coupled to a corresponding one of the driven discs or elements11304 on the adapter side 11307 of the tool mounting plate 6202. SeeFIG. 63. Thus, application of a rotary input motion from the roboticsystem 11000 through the tool drive assembly 11010 to the correspondingdriven element 11304 will cause rotation of the articulation drive gear6322 when the interface 11230 is coupled to the tool holder 11270. Anarticulation driven gear 6324 is attached to a splined shifter shaft6330 that is rotatably supported on the tool mounting plate 6202. Thearticulation driven gear 6324 is in meshing engagement with thearticulation drive gear 6322 as shown. Thus, rotation of thearticulation drive gear 6322 will result in the rotation of the shaft6330. In various forms, a shifter driven gear assembly 6340 is movablysupported on the splined portion 6332 of the shifter shaft 6330.

In various embodiments, the shifter driven gear assembly 6340 includes adriven shifter gear 6342 that is attached to a shifter plate 6344. Theshifter plate 6344 operably interfaces with a shifter solenoid assembly6350. The shifter solenoid assembly 6350 is coupled to correspondingpins 6352 by conductors 6352. See FIG. 168. Pins 6352 are oriented toelectrically communicate with slots 11258 (FIG. 62) on the tool side11244 of the adaptor 11240. Such arrangement serves to electricallycouple the shifter solenoid assembly 6350 to the robotic controller11001. Thus, activation of the shifter solenoid 6350 will shift theshifter driven gear assembly 6340 on the splined portion 6332 of theshifter shaft 6330 as represented by arrow “S” in FIGS. 168 and 169.Various embodiments of the articulation gear train 6300 further includea horizontal gear assembly 6360 that includes a first horizontal drivegear 6362 that is mounted on a shaft 6361 that is rotatably attached tothe tool mounting plate 6202. The first horizontal drive gear 6362 issupported in meshing engagement with a second horizontal drive gear6364. As can be seen in FIG. 169, the horizontal driven gear 6182 is inmeshing engagement with the distal face portion 6365 of the secondhorizontal driven gear 6364.

Various embodiments of the articulation gear train 6300 further includea vertical gear assembly 6370 that includes a first vertical drive gear6372 that is mounted on a shaft 6371 that is rotatably supported on thetool mounting plate 6202. The first vertical drive gear 6372 issupported in meshing engagement with a second vertical drive gear 6374that is concentrically supported with the second horizontal drive gear6364. The second vertical drive gear 6374 is rotatably supported on theproximal spine portion 6110 for travel therearound. The secondhorizontal drive gear 6364 is rotatably supported on a portion of saidsecond vertical drive gear 6374 for independent rotatable travelthereon. As can be seen in FIG. 169, the vertical driven gear 6192 is inmeshing engagement with the distal face portion 6375 of the secondvertical driven gear 6374.

In various forms, the first horizontal drive gear 6362 has a firstdiameter and the first vertical drive gear 6372 has a second diameter.As can be seen in FIGS. 168 and 169, the shaft 6361 is not on a commonaxis with shaft 6371. That is, the first horizontal driven gear 6362 andthe first vertical driven gear 6372 do not rotate about a common axis.Thus, when the shifter gear 6342 is positioned in a center “locking”position such that the shifter gear 6342 is in meshing engagement withboth the first horizontal driven gear 6362 and the first vertical drivegear 6372, the components of the articulation system 6140 are locked inposition. Thus, the shiftable shifter gear 6342 and the arrangement offirst horizontal and vertical drive gears 6362, 6372 as well as thearticulation shifter assembly 6320 collectively may be referred to as anarticulation locking system, generally designated as 6380.

In use, the robotic controller 11001 of the robotic system 11000 maycontrol the articulation system 6140 as follows. To articulate the endeffector 6012 to the left about the first tool articulation axisTA1-TA1, the robotic controller 11001 activates the shifter solenoidassembly 6350 to bring the shifter gear 6342 into meshing engagementwith the first horizontal drive gear 6362. Thereafter, the controller11001 causes a first rotary output motion to be applied to thearticulation drive gear 6322 to drive the shifter gear in a firstdirection to ultimately drive the horizontal driven gear 6182 in anotherfirst direction. The horizontal driven gear 6182 is driven to pivot thearticulation ring 6164 on the ball-shaped portion 6162 to thereby pullright upper cable 6144 and the right lower cable 6146 in the proximaldirection “PD”. To articulate the end effector 6012 to the right aboutthe first tool articulation axis TA1-TA1, the robotic controller 11001activates the shifter solenoid assembly 6350 to bring the shifter gear6342 into meshing engagement with the first horizontal drive gear 6362.Thereafter, the controller 11001 causes the first rotary output motionin an opposite direction to be applied to the articulation drive gear6322 to drive the shifter gear 6342 in a second direction to ultimatelydrive the horizontal driven gear 6182 in another second direction. Suchactions result in the articulation control ring 6164 moving in such amanner as to pull the left upper cable 6150 and the left lower cable6152 in the proximal direction “PD”. In various embodiments the gearratios and frictional forces generated between the gears of the verticalgear assembly 6370 serve to prevent rotation of the vertical driven gear6192 as the horizontal gear assembly 6360 is actuated.

To articulate the end effector 6012 in the upper direction about thesecond tool articulation axis TA2-TA2, the robotic controller 11001activates the shifter solenoid assembly 6350 to bring the shifter gear6342 into meshing engagement with the first vertical drive gear 6372.Thereafter, the controller 11001 causes the first rotary output motionto be applied to the articulation drive gear 6322 to drive the shiftergear 6342 in a first direction to ultimately drive the vertical drivengear 6192 in another first direction. The vertical driven gear 6192 isdriven to pivot the articulation ring 6164 on the ball-shaped portion6162 of the proximal spine portion 6110 to thereby pull right uppercable 6144 and the left upper cable 6150 in the proximal direction “PD”.To articulate the end effector 6012 in the downward direction about thesecond tool articulation axis TA2-TA2, the robotic controller 11001activates the shifter solenoid assembly 6350 to bring the shifter gear6342 into meshing engagement with the first vertical drive gear 6372.Thereafter, the controller 11001 causes the first rotary output motionto be applied in an opposite direction to the articulation drive gear6322 to drive the shifter gear 6342 in a second direction to ultimatelydrive the vertical driven gear 6192 in another second direction. Suchactions thereby cause the articulation control ring 6164 to pull theright lower cable 6146 and the left lower cable 6152 in the proximaldirection “PD”. In various embodiments, the gear ratios and frictionalforces generated between the gears of the horizontal gear assembly 6360serve to prevent rotation of the horizontal driven gear 6182 as thevertical gear assembly 6370 is actuated.

In various embodiments, a variety of sensors may communicate with therobotic controller 11001 to determine the articulated position of theend effector 6012. Such sensors may interface with, for example, thearticulation joint 6100 or be located within the tool mounting portion6200. For example, sensors may be employed to detect the position of thearticulation control ring 6164 on the ball-shaped portion 6162 of theproximal spine portion 6110. Such feedback from the sensors to thecontroller 11001 permits the controller 11001 to adjust the amount ofrotation and the direction of the rotary output to the articulationdrive gear 6322. Further, as indicated above, when the shifter drivegear 6342 is centrally positioned in meshing engagement with the firsthorizontal drive gear 6362 and the first vertical drive gear 6372, theend effector 6012 is locked in the articulated position. Thus, after thedesired amount of articulation has been attained, the controller 11001may activate the shifter solenoid assembly 6350 to bring the shiftergear 6342 into meshing engagement with the first horizontal drive gear6362 and the first vertical drive gear 6372. In alternative embodiments,the shifter solenoid assembly 6350 may be spring activated to thecentral locked position.

In use, it may be desirable to rotate the surgical end effector 6012about the longitudinal tool axis LT-LT. In at least one embodiment, thetransmission arrangement 6204 on the tool mounting portion includes arotational transmission assembly 6400 that is configured to receive acorresponding rotary output motion from the tool drive assembly 11010 ofthe robotic system 11000 and convert that rotary output motion to arotary control motion for rotating the elongated shaft assembly 6008(and surgical end effector 6012) about the longitudinal tool axis LT-LT.In various embodiments, for example, a proximal end portion 6041 of theproximal closure tube 6040 is rotatably supported on the tool mountingplate 6202 of the tool mounting portion 6200 by a forward support cradle6205 and a closure sled 6510 that is also movably supported on the toolmounting plate 6202. In at least one form, the rotational transmissionassembly 6400 includes a tube gear segment 6402 that is formed on (orattached to) the proximal end 6041 of the proximal closure tube 6040 foroperable engagement by a rotational gear assembly 6410 that is operablysupported on the tool mounting plate 6202. As can be seen in FIG. 168,the rotational gear assembly 6410, in at least one embodiment, comprisesa rotation drive gear 6412 that is coupled to a corresponding second oneof the driven discs or elements 11304 on the adapter side 11307 of thetool mounting plate 6202 when the tool mounting portion 6200 is coupledto the tool drive assembly 11010. See FIG. 63. The rotational gearassembly 6410 further comprises a first rotary driven gear 6414 that isrotatably supported on the tool mounting plate 6202 in meshingengagement with the rotation drive gear 6412. The first rotary drivengear 6414 is attached to a drive shaft 6416 that is rotatably supportedon the tool mounting plate 6202. A second rotary driven gear 6418 isattached to the drive shaft 6416 and is in meshing engagement with tubegear segment 6402 on the proximal closure tube 6040. Application of asecond rotary output motion from the tool drive assembly 11010 of therobotic system 11000 to the corresponding driven element 11304 willthereby cause rotation of the rotation drive gear 6412. Rotation of therotation drive gear 6412 ultimately results in the rotation of theelongated shaft assembly 6008 (and the surgical end effector 6012) aboutthe longitudinal tool axis LT-LT. It will be appreciated that theapplication of a rotary output motion from the tool drive assembly 11010in one direction will result in the rotation of the elongated shaftassembly 6008 and surgical end effector 6012 about the longitudinal toolaxis LT-LT in a first direction and an application of the rotary outputmotion in an opposite direction will result in the rotation of theelongated shaft assembly 6008 and surgical end effector 6012 in a seconddirection that is opposite to the first direction.

In at least one embodiment, the closure of the anvil 12024 relative tothe staple cartridge 2034 is accomplished by axially moving a closureportion of the elongated shaft assembly 12008 in the distal direction“DD” on the spine assembly 12049. As indicated above, in variousembodiments, the proximal end portion 6041 of the proximal closure tube6040 is supported by the closure sled 6510 which comprises a portion ofa closure transmission, generally depicted as 6512. As can be seen inFIG. 168, the proximal end portion 6041 of the proximal closure tubeportion 6040 has a collar 6048 formed thereon. The closure sled 6510 iscoupled to the collar 6048 by a yoke 6514 that engages an annular groove6049 in the collar 6048. Such arrangement serves to enable the collar6048 to rotate about the longitudinal tool axis LT-LT while still beingcoupled to the closure transmission 6512. In various embodiments, theclosure sled 6510 has an upstanding portion 6516 that has a closure rackgear 6518 formed thereon. The closure rack gear 6518 is configured fordriving engagement with a closure gear assembly 6520. See FIG. 168.

In various forms, the closure gear assembly 6520 includes a closure spurgear 6522 that is coupled to a corresponding second one of the drivendiscs or elements 11304 on the adapter side 11307 of the tool mountingplate 6202. See FIG. 63. Thus, application of a third rotary outputmotion from the tool drive assembly 11010 of the robotic system 11000 tothe corresponding second driven element 11304 will cause rotation of theclosure spur gear 6522 when the tool mounting portion 6202 is coupled tothe tool drive assembly 11010. The closure gear assembly 6520 furtherincludes a closure reduction gear set 6524 that is supported in meshingengagement with the closure spur gear 6522 and the closure rack gear2106. Thus, application of a third rotary output motion from the tooldrive assembly 11010 of the robotic system 11000 to the correspondingsecond driven element 11304 will cause rotation of the closure spur gear6522 and the closure transmission 6512 and ultimately drive the closuresled 6510 and the proximal closure tube 6040 axially on the proximalspine portion 6110. The axial direction in which the proximal closuretube 6040 moves ultimately depends upon the direction in which the thirddriven element 11304 is rotated. For example, in response to one rotaryoutput motion received from the tool drive assembly 11010 of the roboticsystem 11000, the closure sled 6510 will be driven in the distaldirection “DD” and ultimately drive the proximal closure tube 6040 inthe distal direction “DD”. As the proximal closure tube 6040 is drivendistally, the distal closure tube 6042 is also driven distally by virtueof it connection with the proximal closure tube 6040. As the distalclosure tube 6042 is driven distally, the end of the closure tube 6042will engage a portion of the anvil 6024 and cause the anvil 6024 topivot to a closed position. Upon application of an “opening” out putmotion from the tool drive assembly 11010 of the robotic system 11000,the closure sled 6510 and the proximal closure tube 6040 will be drivenin the proximal direction “PD” on the proximal spine portion 6110. Asthe proximal closure tube 6040 is driven in the proximal direction “PD”,the distal closure tube 6042 will also be driven in the proximaldirection “PD”. As the distal closure tube 6042 is driven in theproximal direction “PD”, the opening 6045 therein interacts with the tab6027 on the anvil 6024 to facilitate the opening thereof. In variousembodiments, a spring (not shown) may be employed to bias the anvil 6024to the open position when the distal closure tube 6042 has been moved toits starting position. In various embodiments, the various gears of theclosure gear assembly 6520 are sized to generate the necessary closureforces needed to satisfactorily close the anvil 6024 onto the tissue tobe cut and stapled by the surgical end effector 6012. For example, thegears of the closure transmission 6520 may be sized to generateapproximately 70-120 pounds of closure forces.

In various embodiments, the cutting instrument is driven through thesurgical end effector 6012 by a knife bar 6530. See FIG. 168. In atleast one form, the knife bar 6530 is fabricated with a jointarrangement (not shown) and/or is fabricated from material that canaccommodate the articulation of the surgical end effector 6102 about thefirst and second tool articulation axes while remaining sufficientlyrigid so as to push the cutting instrument through tissue clamped in thesurgical end effector 6012. The knife bar 6530 extends through a hollowpassage 6532 in the proximal spine portion 6110.

In various embodiments, a proximal end 6534 of the knife bar 6530 isrotatably affixed to a knife rack gear 6540 such that the knife bar 6530is free to rotate relative to the knife rack gear 6540. The distal endof the knife bar 6530 is attached to the cutting instrument in thevarious manners described above. As can be seen in FIG. 168, the kniferack gear 6540 is slidably supported within a rack housing 6542 that isattached to the tool mounting plate 6202 such that the knife rack gear6540 is retained in meshing engagement with a knife drive transmissionportion 6550 of the transmission arrangement 6204. In variousembodiments, the knife drive transmission portion 6550 comprises a knifegear assembly 6560. More specifically and with reference to FIG. 168, inat least one embodiment, the knife gear assembly 6560 includes a knifespur gear 6562 that is coupled to a corresponding fourth one of thedriven discs or elements 11304 on the adapter side 11307 of the toolmounting plate 6202. See FIG. 63. Thus, application of another rotaryoutput motion from the robotic system 11000 through the tool driveassembly 11010 to the corresponding fourth driven element 11304 willcause rotation of the knife spur gear 6562. The knife gear assembly 6560further includes a knife gear reduction set 6564 that includes a firstknife driven gear 6566 and a second knife drive gear 6568. The knifegear reduction set 6564 is rotatably mounted to the tool mounting plate6202 such that the firs knife driven gear 6566 is in meshing engagementwith the knife spur gear 6562. Likewise, the second knife drive gear6568 is in meshing engagement with a third knife drive gear assembly6570. As shown in FIG. 168, the second knife driven gear 6568 is inmeshing engagement with a fourth knife driven gear 6572 of the thirdknife drive gear assembly 6570. The fourth knife driven gear 6572 is inmeshing engagement with a fifth knife driven gear assembly 6574 that isin meshing engagement with the knife rack gear 6540. In variousembodiments, the gears of the knife gear assembly 6560 are sized togenerate the forces needed to drive the cutting instrument through thetissue clamped in the surgical end effector 6012 and actuate the staplestherein. For example, the gears of the knife gear assembly 6560 may besized to generate approximately 40 to 100 pounds of driving force. Itwill be appreciated that the application of a rotary output motion fromthe tool drive assembly 11010 in one direction will result in the axialmovement of the cutting instrument in a distal direction and applicationof the rotary output motion in an opposite direction will result in theaxial travel of the cutting instrument in a proximal direction.

As can be appreciated from the foregoing description, the surgical tool6000 represents a vast improvement over prior robotic tool arrangements.The unique and novel transmission arrangement employed by the surgicaltool 6000 enables the tool to be operably coupled to a tool holderportion 11010 of a robotic system that only has four rotary outputbodies, yet obtain the rotary output motions therefrom to: (i)articulate the end effector about two different articulation axes thatare substantially transverse to each other as well as the longitudinaltool axis; (ii) rotate the end effector 6012 about the longitudinal toolaxis; (iii) close the anvil 6024 relative to the surgical staplecartridge 6034 to varying degrees to enable the end effector 6012 to beused to manipulate tissue and then clamp it into position for cuttingand stapling; and (iv) firing the cutting instrument to cut through thetissue clamped within the end effector 6012. The unique and novelshifter arrangements of various embodiments of the present inventiondescribed above enable two different articulation actions to be poweredfrom a single rotatable body portion of the robotic system.

The various embodiments of the present invention have been describedabove in connection with cutting-type surgical instruments. It should benoted, however, that in other embodiments, the inventive surgicalinstrument disclosed herein need not be a cutting-type surgicalinstrument, but rather could be used in any type of surgical instrumentincluding remote sensor transponders. For example, it could be anon-cutting endoscopic instrument, a grasper, a stapler, a clip applier,an access device, a drug/gene therapy delivery device, an energy deviceusing ultrasound, RF, laser, etc. In addition, the present invention maybe in laparoscopic instruments, for example. The present invention alsohas application in conventional endoscopic and open surgicalinstrumentation as well as robotic-assisted surgery.

FIG. 170 depicts use of various aspects of certain embodiments of thepresent invention in connection with a surgical tool 7000 that has anultrasonically powered end effector 7012. The end effector 7012 isoperably attached to a tool mounting portion 7100 by an elongated shaftassembly 7008. The tool mounting portion 7100 may be substantiallysimilar to the various tool mounting portions described hereinabove. Inone embodiment, the end effector 7012 includes an ultrasonically poweredjaw portion 7014 that is powered by alternating current or directcurrent in a known manner. Such ultrasonically-powered devices aredisclosed, for example, in U.S. Pat. No. 6,783,524, entitled ROBOTICSURGICAL TOOL WITH ULTRASOUND CAUTERIZING AND CUTTING INSTRUMENT, theentire disclosure of which is herein incorporated by reference. In theillustrated embodiment, a separate power cord 7020 is shown. It will beunderstood, however, that the power may be supplied thereto from therobotic controller 11001 through the tool mounting portion 7100. Thesurgical end effector 7012 further includes a movable jaw 7016 that maybe used to clamp tissue onto the ultrasonic jaw portion 7014. Themovable jaw portion 7016 may be selectively actuated by the roboticcontroller 11001 through the tool mounting portion 7100 in anyone of thevarious manners herein described.

FIG. 171 illustrates use of various aspects of certain embodiments ofthe present invention in connection with a surgical tool 8000 that hasan end effector 8012 that comprises a linear stapling device. The endeffector 8012 is operably attached to a tool mounting portion 8100 by anelongated shaft assembly 3700 of the type and construction describeabove. However, the end effector 8012 may be attached to the toolmounting portion 8100 by a variety of other elongated shaft assembliesdescribed herein. In one embodiment, the tool mounting portion 8100 maybe substantially similar to tool mounting portion 3750. However, variousother tool mounting portions and their respective transmissionarrangements describe in detail herein may also be employed. Such linearstapling head portions are also disclosed, for example, in U.S. Pat. No.7,673,781, entitled SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THATSUPPORTS MULTIPLE WIRE DIAMETER STAPLES, the entire disclosure of whichis herein incorporated by reference.

Surgical Tools and Interfaces with Various Sensor Embodiments

Various sensor embodiments described in U.S. Patent Publication No.2011/0062212 A1 to Shelton, IV et al., the disclosure of which is hereinincorporated by reference in its entirety, may be employed with many ofthe surgical tool embodiments disclosed herein. As was indicated above,the master controller 11001 generally includes master controllers(generally represented by 11003) which are grasped by the surgeon andmanipulated in space while the surgeon views the procedure via a stereodisplay 11002. See FIG. 54. The master controllers 11001 are manualinput devices which preferably move with multiple degrees of freedom,and which often further have an actuatable handle for actuating thesurgical tools. Some of the surgical tool embodiments disclosed hereinemploy a motor or motors in their tool drive portion to supply variouscontrol motions to the tool's end effector. Such embodiments may alsoobtain additional control motion(s) from the motor arrangement employedin the robotic system components. Other embodiments disclosed hereinobtain all of the control motions from motor arrangements within therobotic system.

Such motor powered arrangements may employ various sensor arrangementsthat are disclosed in the published US patent application cited above toprovide the surgeon with a variety of forms of feedback withoutdeparting from the spirit and scope of the present invention. Forexample, those master controller arrangements 11003 that employ amanually actuatable firing trigger can employ run motor sensor(s) toprovide the surgeon with feedback relating to the amount of forceapplied to or being experienced by the cutting member. The run motorsensor(s) may be configured for communication with the firing triggerportion to detect when the firing trigger portion has been actuated tocommence the cutting/stapling operation by the end effector. The runmotor sensor may be a proportional sensor such as, for example, arheostat or variable resistor. When the firing trigger is drawn in, thesensor detects the movement, and sends an electrical signal indicativeof the voltage (or power) to be supplied to the corresponding motor.When the sensor is a variable resistor or the like, the rotation of themotor may be generally proportional to the amount of movement of thefiring trigger. That is, if the operator only draws or closes the firingtrigger in a small amount, the rotation of the motor is relatively low.When the firing trigger is fully drawn in (or in the fully closedposition), the rotation of the motor is at its maximum. In other words,the harder the surgeon pulls on the firing trigger, the more voltage isapplied to the motor causing greater rates of rotation. Otherarrangements may provide the surgeon with a feed back meter 11005 thatmay be viewed through the display 11002 and provide the surgeon with avisual indication of the amount of force being applied to the cuttinginstrument or dynamic clamping member. Other sensor arrangements may beemployed to provide the master controller 11001 with an indication as tothe position of the knife in the elongate channel, whether a staplecartridge has been loaded into the end effector, whether the anvil hasbeen moved to a closed position prior to firing, etc.

In still other embodiments, the various robotic systems and toolsdisclosed herein may employ many of the sensor/transponder arrangementsdisclosed above. Such sensor arrangements may include, but are notlimited to, knife position sensors, run motor sensors, reverse motorsensors, stop motor sensors, end-of-stroke sensors, beginning-of-strokesensors, cartridge lockout sensors, sensor transponders, etc. Thesensors may be employed in connection with any of the surgical toolsdisclosed herein that are adapted for use with a robotic system. Thesensors may be configured to communicate with the robotic systemcontroller. For example, in an embodiment shown in FIGS. 41-53, thesensors may communicate with a memory device 2001. The memory device2001 may comprise a portion of the robotic system 11000. Alternatively,the memory device 2001 may be external to the robotic system, but mayotherwise be in electrical communication with the robotic system 11000.

In other embodiments, components of the shaft/end effector may serve asantennas to communicate between the sensors and the robotic controller11001. Various antenna embodiments are described in U.S. Pat. No.8,684,253, to James R. Giordano et al., the disclosure of which isherein incorporated by reference in its entirety. Referring to FIG. 172,sensors (not shown) in the end effector 12 may transmit a signal tointermediate inductive element 2054 a along an insulated conductive wire2050 from the sensor(s) to the intermediate inductive element 2054 a.Alternatively, the sensor(s) may wirelessly transmit the signal from aninductive element in electrical communication with the sensor(s) to anintermediate inductive element 2054 along the shaft 8 or end effector 12of the instrument 10. The first intermediate inductive element 2054 amay wirelessly transmit the signal to another intermediate inductiveelement 2054 b or to the controller 11001 of other component within therobotic system 11000.

Upon receiving a signal from a sensor(s), the robotic system 11000 maydetermine the sensed condition and communicate the condition to the uservia a visual indication screen 11002. Additionally or alternatively, thesensed condition(s) may be communicated to the user by a hapticindication. For example, as the signals from the knife position sensor2008 indicate that the cutting instrument is reaching the end of thestaple channel, the user may be alerted by increased resistance from thetrigger on the master controller 11001.

In alternative embodiments, a motor-controlled interface may be employedin connection with the controller 11001 that limits the maximum triggerpull based on the amount of loading (e.g., clamping force, cuttingforce, etc.) experienced by the surgical end effector. For example, theamount of resistive force experienced during activation of the triggerwould correspond to the amount of resistance experienced by the cuttinginstrument as it is advanced through the tissue clamped within the endeffector. In still other embodiments, the trigger on the controller11001 is arranged such that the trigger pull location is proportionateto the end effector-location/condition. For example, the trigger is onlyfully depressed when the end effector is fully fired. The conditions ofthe end effector may be determined by sensor arrangements in the endeffector. Sensor arrangements include knife position sensors, run motorsensors, reverse motor sensors, stop motor sensors, end-of-strokesensors, beginning-of-stroke sensors, cartridge lockout sensors, sensortransponders, etc. The knife position sensor 2008 may communicate theposition of the cutting instrument to the robotic system 11000. Forexample, when signals from the knife position sensor indicate that thecutting instrument has reached the distal position in the staplechannel, the trigger on the controller 11001 of the robotics system11000 may be fully depressed, thus terminating the cutting stroke.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Although the present invention has been described herein in connectionwith certain disclosed embodiments, many modifications and variations tothose embodiments may be implemented. For example, different types ofend effectors may be employed. Also, where materials are disclosed forcertain components, other materials may be used. The foregoingdescription and following claims are intended to cover all suchmodification and variations.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. A surgical instrument comprising: a roboticssystem; a surgical end effector comprising: an elongate channelcomprising an interior surface, wherein said interior surface comprisesa plurality of sensors; and a firing bar comprising a magnetic element;wherein said firing bar is configured to translate between positionswithin said elongate channel in response to drive motions impartedthereto from said robotics system; a memory device operably interfacingwith said plurality of sensors to record the positions of said magneticelement.
 2. The surgical instrument of claim 1, wherein said interiorsurface comprises a slot and wherein said magnetic element translatesalong said slot within said elongate channel.
 3. The surgical instrumentof claim 2, wherein said plurality of sensors comprises a first sensorproximate to said translating magnetic element and a second sensordistal to said translating magnetic element.
 4. The surgical instrumentof claim 1, wherein said plurality of sensors are Hall Effect Sensors.5. The surgical instrument of claim 1, wherein said end effector furthercomprises a staple cartridge.
 6. The surgical instrument of claim 1further comprising a means for indicating said positions recorded bysaid memory device.
 7. The surgical instrument of claim 6, wherein saidmeans for indicating comprises a visual indication device.
 8. Thesurgical instrument of claim 6, wherein said means for indicatingcomprises a haptic indication arrangement.
 9. The surgical instrument ofclaim 1, wherein said memory device communicates said positions of saidmagnetic element to said robotics system.
 10. The surgical instrument ofclaim 1, wherein said memory device wirelessly interfaces with saidplurality of sensors.
 11. A surgical instrument comprising: a roboticssystem; a surgical end effector comprising: an elongate channel; afiring bar comprising a magnetic element; wherein said firing bar isconfigured to translate between positions within said elongate channelin response to drive motions imparted thereto from said robotics system;a coil positioned around a portion of said firing bar; a memory deviceoperably interfacing with said coil to record said positions of saidmagnetic element.
 12. The surgical instrument of claim 11, wherein saidend effector further comprises a staple cartridge.
 13. The surgicalinstrument of claim 11, further comprising a means for indicating saidpositions recorded by said memory device.
 14. The surgical instrument ofclaim 13, wherein said means for indicating comprises a visualindication device.
 15. The surgical instrument of claim 13, wherein saidmeans for indicating comprises a haptic indication arrangement.
 16. Thesurgical instrument of claim 11, wherein said memory device communicatessaid positions of said magnetic element to said robotics system.
 17. Thesurgical instrument of claim 11, wherein said memory device wirelesslyinterfaces with said plurality of sensors.